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 $295.12 Median $3,467.37 Typical High $5,623.41 | Facility | None | $295.12 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $380.19 | Professional | None | $251.19 | $316.23 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $467.74 | Professional | None | $457.09 | $457.09 | $467.74 |
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 $245.47 Median $288.40 Typical High $380.19 | Professional | None | $245.47 | $288.40 | $380.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $436.52 Typical High $588.84 | Professional | 50 · Both sides | $363.08 | $436.52 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $323.59 | Facility | None | $269.15 | $269.15 | $323.59 |
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 $302.00 Median $363.08 Typical High $676.08 | Professional | None | $302.00 | $363.08 | $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 $354.81 Median $489.78 Typical High $676.08 | Professional | None | $354.81 | $489.78 | $676.08 |
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 $257.04 Median $323.59 Typical High $562.34 | Professional | None | $257.04 | $323.59 | $562.34 |
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 $141.25 Median $154.88 Typical High $169.82 | Professional | 52 · Reduced service | $141.25 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $63.10 Typical High $67.61 | Professional | 53 · Discontinued | $56.23 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $208.93 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $46.77 Typical High $51.29 | Professional | 55 · Aftercare only | $42.66 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $31.62 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.18 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $218.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $194.98 | $218.78 | $234.42 |
Where Indiana sits
The same service costs 5.9 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
$316
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.