How much rates vary
Facilitymedian $1,698 · 10th to 90th $209 to $5,129Professionalmedian $302 · 10th to 90th $229 to $490
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 $275.42 Median $3,467.37 Typical High $5,623.41 | Facility | None | $275.42 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $416.87 | Professional | None | $239.88 | $302.00 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $407.38 | Professional | None | $263.03 | $309.03 | $407.38 |
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 $229.09 Median $269.15 Typical High $363.08 | Professional | None | $229.09 | $269.15 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $407.38 Typical High $549.54 | Professional | 50 · Both sides | $346.74 | $407.38 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $295.12 | Facility | None | $269.15 | $269.15 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $416.87 | Professional | None | $295.12 | $323.59 | $416.87 |
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 $288.40 Median $346.74 Typical High $660.69 | Professional | None | $288.40 | $346.74 | $660.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $776.25 Typical High $1,023.29 | Facility | None | $229.09 | $776.25 | $1,023.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $630.96 | Professional | None | $323.59 | $457.09 | $630.96 |
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 $239.88 Median $302.00 Typical High $537.03 | Professional | None | $239.88 | $302.00 | $537.03 |
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 $131.83 Median $147.91 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $58.88 Typical High $64.57 | Professional | 53 · Discontinued | $52.48 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $218.78 Typical High $239.88 | Professional | 54 · Surgery only | $199.53 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $43.65 Typical High $47.86 | Professional | 55 · Aftercare only | $39.81 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $29.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.30 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $204.17 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $186.21 | $204.17 | $223.87 |
Where Indiana sits
The same service costs 5.5 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· 46th of 51
$302
AK $1,202UT $219
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.