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 $707.95 Median $758.58 Typical High $7,244.36 | Facility | None | $707.95 | $758.58 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $676.08 | Professional | None | $537.03 | $588.84 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,413.10 Typical High $17,378.01 | Facility | None | $758.58 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $1,000.00 | Professional | None | $549.54 | $758.58 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,148.15 Typical High $1,513.56 | Professional | 50 · Both sides | $831.76 | $1,148.15 | $1,513.56 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $3,235.94 | Facility | None | $645.65 | $645.65 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,905.46 Typical High $3,467.37 | Facility | None | $562.34 | $1,905.46 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $3,630.78 | Professional | None | $616.60 | $724.44 | $3,630.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,584.89 Median $3,388.44 Typical High $5,248.07 | Facility | None | $1,584.89 | $3,388.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,258.93 | Professional | None | $660.69 | $912.01 | $1,258.93 |
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 $512.86 Median $660.69 Typical High $1,122.02 | Professional | None | $512.86 | $660.69 | $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 $269.15 Median $295.12 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $128.82 | Professional | 53 · Discontinued | $107.15 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $489.78 | Professional | 54 · Surgery only | $407.38 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $457.09 |
Where Indiana sits
The same service costs 18.6 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· 33rd of 51
$759
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.