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 $457.09 Median $3,467.37 Typical High $5,623.41 | Facility | None | $457.09 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $537.03 | Professional | None | $436.52 | $489.78 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $3,162.28 Typical High $5,888.44 | Facility | None | $602.56 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $758.58 | Professional | None | $436.52 | $575.44 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $870.96 Typical High $1,174.90 | Professional | 50 · Both sides | $660.69 | $870.96 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $501.19 | Facility | None | $269.15 | $269.15 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $354.81 Typical High $1,071.52 | Facility | None | $162.18 | $354.81 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $1,071.52 | Professional | None | $489.78 | $575.44 | $1,071.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $776.25 Typical High $1,698.24 | Facility | None | $229.09 | $776.25 | $1,698.24 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $1,071.52 | Professional | None | $524.81 | $741.31 | $1,071.52 |
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 $398.11 Median $501.19 Typical High $870.96 | Professional | None | $398.11 | $501.19 | $870.96 |
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 $218.78 Median $245.47 Typical High $263.03 | Professional | 52 · Reduced service | $218.78 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $87.10 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $363.08 Typical High $398.11 | Professional | 54 · Surgery only | $323.59 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $43.65 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $338.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $302.00 | $338.84 | $371.54 |
Where Indiana sits
The same service costs 5.8 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· 36th of 51
$550
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.