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 $794.33 Median $5,011.87 Typical High $14,125.38 | Facility | None | $794.33 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $912.01 | Professional | None | $741.31 | $794.33 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,122.02 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,230.27 | Professional | None | $741.31 | $933.25 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $3,235.94 | Facility | None | $891.25 | $891.25 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,454.71 Typical High $3,548.13 | Facility | None | $776.25 | $2,454.71 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $5,888.44 | Professional | None | $776.25 | $954.99 | $5,888.44 |
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 $812.83 Median $1,202.26 Typical High $1,698.24 | Professional | None | $812.83 | $1,202.26 | $1,698.24 |
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 $691.83 Median $870.96 Typical High $1,513.56 | Professional | None | $691.83 | $870.96 | $1,513.56 |
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 $363.08 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $616.60 |
Where Indiana sits
The same service costs 7.1 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· 37th of 51
$933
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.