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 $229.09 Median $3,467.37 Typical High $5,623.41 | Facility | None | $229.09 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $245.47 | Professional | None | $208.93 | $229.09 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $295.12 | Professional | None | $190.55 | $223.87 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $281.84 Median $331.13 Typical High $446.68 | Professional | 50 · Both sides | $281.84 | $331.13 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $1,737.80 | Facility | None | $251.19 | $251.19 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $1,047.13 Typical High $1,819.70 | Facility | None | $281.84 | $1,047.13 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $467.74 | Professional | None | $218.78 | $257.04 | $467.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $691.83 Median $1,862.09 Typical High $2,398.83 | Facility | None | $691.83 | $1,862.09 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $512.86 | Professional | None | $275.42 | $363.08 | $512.86 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $407.38 | Professional | None | $186.21 | $229.09 | $407.38 |
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 $104.71 Median $114.82 Typical High $123.03 | Professional | 52 · Reduced service | $104.71 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $45.71 Typical High $48.98 | Professional | 53 · Discontinued | $41.69 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $173.78 Typical High $186.21 | Professional | 54 · Surgery only | $154.88 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $34.67 Typical High $37.15 | Professional | 55 · Aftercare only | $31.62 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.91 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.89 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $162.18 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $144.54 | $162.18 | $173.78 |
Where Indiana sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 44th of 51
$234
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.