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 $263.03 Median $3,467.37 Typical High $11,220.18 | Facility | None | $263.03 | $3,467.37 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $323.59 | Professional | None | $251.19 | $269.15 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $891.25 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $389.05 | Professional | None | $223.87 | $275.42 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $1,737.80 | Facility | None | $288.40 | $288.40 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,096.48 Typical High $2,290.87 | Facility | None | $436.52 | $1,096.48 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $691.83 | Professional | None | $295.12 | $371.54 | $691.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $870.96 Median $1,548.82 Typical High $2,344.23 | Facility | None | $870.96 | $1,548.82 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $645.65 | Professional | None | $309.03 | $436.52 | $645.65 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $562.34 | Professional | None | $245.47 | $316.23 | $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 $131.83 Median $134.90 Typical High $151.36 | Professional | 52 · Reduced service | $131.83 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $52.48 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $194.98 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $40.74 Typical High $45.71 | Professional | 55 · Aftercare only | $38.90 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.92 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.30 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $190.55 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $181.97 | $190.55 | $213.80 |
Where Indiana sits
The same service costs 6.8 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· 41st 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.