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 $331.13 Median $3,467.37 Typical High $5,623.41 | Facility | None | $331.13 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $512.86 | Professional | None | $323.59 | $363.08 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $501.19 | Professional | None | $446.68 | $478.63 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $3,162.28 Typical High $5,888.44 | Facility | None | $602.56 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $436.52 | Professional | None | $275.42 | $323.59 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $489.78 Typical High $660.69 | Professional | 50 · Both sides | $416.87 | $489.78 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Facility | None | $269.15 | $269.15 | $363.08 |
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 $354.81 Median $426.58 Typical High $758.58 | Professional | None | $354.81 | $426.58 | $758.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $1,288.25 | Facility | None | $213.80 | $346.74 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $812.83 | Professional | None | $398.11 | $562.34 | $812.83 |
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 $288.40 Median $363.08 Typical High $645.65 | Professional | None | $288.40 | $363.08 | $645.65 |
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 $162.18 Median $181.97 Typical High $194.98 | Professional | 52 · Reduced service | $162.18 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $72.44 Typical High $79.43 | Professional | 53 · Discontinued | $64.57 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | 54 · Surgery only | $239.88 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $36.31 Typical High $38.90 | Professional | 56 · Pre-op care only | $32.36 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $251.19 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $223.87 | $251.19 | $275.42 |
Where Indiana sits
The same service costs 5.1 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
$372
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.