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 $275.42 Median $831.76 Typical High $5,623.41 | Facility | None | $275.42 | $831.76 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $389.05 | Professional | None | $245.47 | $275.42 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
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 $323.59 | Professional | None | $204.17 | $239.88 | $323.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $354.81 Typical High $478.63 | Professional | 50 · Both sides | $302.00 | $354.81 | $478.63 |
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 $66.07 Median $208.93 Typical High $354.81 | Facility | None | $66.07 | $208.93 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $549.54 | Professional | None | $239.88 | $295.12 | $549.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $741.31 Typical High $977.24 | Facility | None | $229.09 | $741.31 | $977.24 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $602.56 | Professional | None | $302.00 | $416.87 | $602.56 |
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 $204.17 Median $269.15 Typical High $467.74 | Professional | None | $204.17 | $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 $123.03 Median $131.83 Typical High $147.91 | Professional | 52 · Reduced service | $123.03 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $53.70 Typical High $58.88 | Professional | 53 · Discontinued | $48.98 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $199.53 Typical High $223.87 | Professional | 54 · Surgery only | $186.21 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $39.81 Typical High $44.67 | Professional | 55 · Aftercare only | $37.15 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $26.92 Typical High $29.51 | Professional | 56 · Pre-op care only | $24.55 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $186.21 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $173.78 | $186.21 | $208.93 |
Where Indiana sits
The same service costs 5.4 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· 43rd of 51
$275
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.