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 $389.05 Median $5,011.87 Typical High $5,623.41 | Facility | None | $389.05 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $436.52 | Professional | None | $354.81 | $389.05 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $7,413.10 Typical High $17,378.01 | Facility | None | $724.44 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $588.84 | Professional | None | $354.81 | $446.68 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $660.69 Typical High $891.25 | Professional | 50 · Both sides | $524.81 | $660.69 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $3,235.94 | Facility | None | $426.58 | $426.58 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $3,548.13 | Facility | None | $407.38 | $2,137.96 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $2,290.87 | Professional | None | $389.05 | $457.09 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $4,677.35 | Facility | None | $912.01 | $2,454.71 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $851.14 | Professional | None | $380.19 | $588.84 | $851.14 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $707.95 | Professional | None | $323.59 | $407.38 | $707.95 |
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 $177.83 Median $190.55 Typical High $208.93 | Professional | 52 · Reduced service | $177.83 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $83.18 | Professional | 53 · Discontinued | $70.79 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $288.40 Typical High $316.23 | Professional | 54 · Surgery only | $263.03 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $63.10 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $41.69 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $269.15 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $245.47 | $269.15 | $295.12 |
Where Indiana sits
The same service costs 8.1 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· 37th of 51
$447
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.