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 $676.08 Median $5,011.87 Typical High $11,220.18 | Facility | None | $676.08 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $776.25 | Professional | None | $630.96 | $676.08 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,230.27 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,096.48 | Professional | None | $630.96 | $831.76 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,230.27 Typical High $1,659.59 | Professional | 50 · Both sides | $954.99 | $1,230.27 | $1,659.59 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $3,235.94 | Facility | None | $758.58 | $758.58 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $3,467.37 | Facility | None | $645.65 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $3,981.07 | Professional | None | $691.83 | $812.83 | $3,981.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $4,677.35 | Facility | None | $912.01 | $2,454.71 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,445.44 | Professional | None | $776.25 | $1,023.29 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,288.25 | Professional | None | $588.84 | $741.31 | $1,288.25 |
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 $316.23 Median $338.84 Typical High $380.19 | Professional | 52 · Reduced service | $316.23 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $467.74 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $524.81 |
Where Indiana sits
The same service costs 7.8 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· 35th of 51
$832
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.