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 $562.34 Median $5,011.87 Typical High $11,220.18 | Facility | None | $562.34 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $645.65 | Professional | None | $512.86 | $562.34 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,122.02 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $1,096.48 | Professional | None | $524.81 | $831.76 | $1,096.48 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $7,244.36 | Facility | None | $616.60 | $616.60 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,786.30 Typical High $7,943.28 | Facility | None | $630.96 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $5,370.32 | Professional | None | $602.56 | $707.95 | $5,370.32 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,248.07 Typical High $10,471.29 | Facility | None | $912.01 | $5,248.07 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,202.26 | Professional | None | $630.96 | $851.14 | $1,202.26 |
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 $489.78 Median $645.65 Typical High $1,071.52 | Professional | None | $489.78 | $645.65 | $1,071.52 |
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 $257.04 Median $281.84 Typical High $309.03 | Professional | 52 · Reduced service | $257.04 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $125.89 | Professional | 53 · Discontinued | $104.71 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $389.05 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $363.08 | $398.11 | $436.52 |
Where Indiana sits
The same service costs 8.1 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· 26th 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.