How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $7,244.36 | Facility | None | $741.31 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $933.25 | Professional | None | $741.31 | $776.25 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,000.00 | Professional | None | $537.03 | $758.58 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,148.15 Typical High $1,548.82 | Professional | 50 · Both sides | $812.83 | $1,148.15 | $1,548.82 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $1,348.96 | Facility | None | $741.31 | $741.31 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $1,862.09 | Facility | None | $549.54 | $1,000.00 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $758.58 Typical High $1,513.56 | Professional | None | $323.59 | $758.58 | $1,513.56 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $977.24 Median $1,659.59 Typical High $2,818.38 | Facility | None | $977.24 | $1,659.59 | $2,818.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,819.70 | Professional | None | $831.76 | $1,258.93 | $1,819.70 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $1,348.96 | Professional | None | $524.81 | $707.95 | $1,348.96 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $389.05 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $575.44 Typical High $707.95 | Professional | 54 · Surgery only | $549.54 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $114.82 Typical High $141.25 | Professional | 55 · Aftercare only | $112.20 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $537.03 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $512.86 | $537.03 | $660.69 |
Where Indiana sits
The same service costs 5.5 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 43rd of 51
$759
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.