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 $151.36 Median $3,801.89 Typical High $5,623.41 | Facility | None | $151.36 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $257.04 | Professional | None | $151.36 | $204.17 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $245.47 | Professional | None | $138.04 | $177.83 | $245.47 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $269.15 Typical High $371.54 | Professional | 50 · Both sides | $208.93 | $269.15 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $354.81 | Facility | None | $165.96 | $165.96 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $323.59 Typical High $602.56 | Facility | None | $199.53 | $323.59 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $416.87 | Professional | None | $169.82 | $269.15 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $331.13 Median $691.83 Typical High $2,344.23 | Facility | None | $331.13 | $691.83 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $501.19 | Professional | None | $181.97 | $316.23 | $501.19 |
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 $144.54 Median $223.87 Typical High $389.05 | Professional | None | $144.54 | $223.87 | $389.05 |
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 $75.86 Median $102.33 Typical High $125.89 | Professional | 52 · Reduced service | $75.86 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $40.74 Typical High $51.29 | Professional | 53 · Discontinued | $30.20 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $154.88 Typical High $190.55 | Professional | 54 · Surgery only | $114.82 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.90 Typical High $38.02 | Professional | 55 · Aftercare only | $22.91 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $20.42 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.14 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $144.54 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $107.15 | $144.54 | $177.83 |
Where Indiana sits
The same service costs 3.7 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· 42nd of 51
$224
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.