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 $549.54 Median $3,467.37 Typical High $7,244.36 | Facility | None | $549.54 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $691.83 | Professional | None | $549.54 | $588.84 | $691.83 |
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 $338.84 Median $398.11 Typical High $549.54 | Professional | None | $338.84 | $398.11 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $1,348.96 | Facility | None | $575.44 | $575.44 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $870.96 Typical High $1,698.24 | Facility | None | $562.34 | $870.96 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $676.08 Typical High $1,258.93 | Professional | None | $338.84 | $676.08 | $1,258.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $977.24 Median $1,659.59 Typical High $2,187.76 | Facility | None | $977.24 | $1,659.59 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,348.96 | Professional | None | $630.96 | $954.99 | $1,348.96 |
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 $478.63 Median $630.96 Typical High $1,122.02 | Professional | None | $478.63 | $630.96 | $1,122.02 |
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 $275.42 Median $288.40 Typical High $346.74 | Professional | 52 · Reduced service | $275.42 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $138.04 | Professional | 53 · Discontinued | $109.65 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $426.58 Typical High $512.86 | Professional | 54 · Surgery only | $416.87 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $85.11 Typical High $102.33 | Professional | 55 · Aftercare only | $83.18 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $57.54 Typical High $69.18 | Professional | 56 · Pre-op care only | $54.95 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $398.11 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $389.05 | $398.11 | $478.63 |
Where Indiana sits
The same service costs 5.6 times more in Alaska than in Texas. 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· 45th of 51
$589
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.