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 $288.40 Median $3,467.37 Typical High $5,623.41 | Facility | None | $288.40 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $436.52 | Professional | None | $275.42 | $309.03 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $323.59 | Professional | None | $213.80 | $323.59 | $323.59 |
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 $234.42 Median $275.42 Typical High $371.54 | Professional | None | $234.42 | $275.42 | $371.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $416.87 Typical High $562.34 | Professional | 50 · Both sides | $354.81 | $416.87 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $316.23 | Facility | None | $269.15 | $269.15 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $269.15 Typical High $794.33 | Facility | None | $162.18 | $269.15 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $676.08 | Professional | None | $295.12 | $354.81 | $676.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $776.25 Typical High $1,096.48 | Facility | None | $229.09 | $776.25 | $1,096.48 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $691.83 | Professional | None | $346.74 | $478.63 | $691.83 |
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 $245.47 Median $309.03 Typical High $549.54 | Professional | None | $245.47 | $309.03 | $549.54 |
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 $138.04 Median $154.88 Typical High $165.96 | Professional | 52 · Reduced service | $138.04 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $66.07 | Professional | 53 · Discontinued | $54.95 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $204.17 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $50.12 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.90 Typical High $33.11 | Professional | 56 · Pre-op care only | $27.54 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $218.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $190.55 | $218.78 | $234.42 |
Where Indiana sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 45th of 51
$309
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.