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 $977.24 Median $5,011.87 Typical High $11,220.18 | Facility | None | $977.24 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,122.02 | Professional | None | $912.01 | $977.24 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,047.13 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,174.90 | Professional | None | $741.31 | $870.96 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $3,235.94 | Facility | None | $1,096.48 | $1,096.48 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,019.95 Typical High $5,128.61 | Facility | None | $630.96 | $3,019.95 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,096.48 Typical High $5,754.40 | Professional | None | $602.56 | $1,096.48 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,884.03 Typical High $5,370.32 | Facility | None | $912.01 | $2,884.03 | $5,370.32 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $812.83 Median $1,479.11 Typical High $2,089.30 | Professional | None | $812.83 | $1,479.11 | $2,089.30 |
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 $575.44 Median $1,023.29 Typical High $1,862.09 | Professional | None | $575.44 | $1,023.29 | $1,862.09 |
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 $457.09 Median $489.78 Typical High $549.54 | Professional | 52 · Reduced service | $457.09 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $218.78 | Professional | 53 · Discontinued | $181.97 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $109.65 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $758.58 |
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· 43rd of 51
$977
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.