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 $524.81 Median $5,011.87 Typical High $7,244.36 | Facility | None | $524.81 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $602.56 | Professional | None | $478.63 | $524.81 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $7,413.10 Typical High $17,378.01 | Facility | None | $741.31 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $912.01 | Professional | None | $501.19 | $691.83 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,023.29 Typical High $1,348.96 | Professional | 50 · Both sides | $741.31 | $1,023.29 | $1,348.96 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $4,265.80 | Facility | None | $575.44 | $575.44 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,630.27 Typical High $4,897.79 | Facility | None | $562.34 | $2,630.27 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $4,265.80 | Professional | None | $562.34 | $707.95 | $4,265.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,412.54 Median $3,890.45 Typical High $5,754.40 | Facility | None | $1,412.54 | $3,890.45 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,148.15 | Professional | None | $524.81 | $812.83 | $1,148.15 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $977.24 | Professional | None | $446.68 | $588.84 | $977.24 |
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 $239.88 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $239.88 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $95.50 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $363.08 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $407.38 |
Where Indiana sits
The same service costs 7.9 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· 33rd of 51
$692
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.