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 $245.47 Median $3,801.89 Typical High $5,623.41 | Facility | None | $245.47 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $346.74 | Professional | None | $234.42 | $257.04 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $316.23 | Professional | None | $204.17 | $239.88 | $316.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $309.03 Median $363.08 Typical High $489.78 | Professional | 50 · Both sides | $309.03 | $363.08 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $269.15 Typical High $794.33 | Facility | None | $162.18 | $269.15 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $549.54 | Professional | None | $257.04 | $302.00 | $549.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $954.99 | Facility | None | $213.80 | $346.74 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $575.44 | Professional | None | $302.00 | $416.87 | $575.44 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $467.74 | Professional | None | $208.93 | $269.15 | $467.74 |
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 $114.82 Median $128.82 Typical High $138.04 | Professional | 52 · Reduced service | $114.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $51.29 Typical High $56.23 | Professional | 53 · Discontinued | $45.71 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $194.98 Typical High $208.93 | Professional | 54 · Surgery only | $173.78 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.90 Typical High $41.69 | Professional | 55 · Aftercare only | $34.67 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $28.18 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $181.97 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $162.18 | $181.97 | $194.98 |
Where Indiana sits
The same service costs 5.9 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· 42nd of 51
$269
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.