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 $691.83 Median $5,011.87 Typical High $11,220.18 | Facility | None | $691.83 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $776.25 | Professional | None | $616.60 | $691.83 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,047.13 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $977.24 | Professional | None | $588.84 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $467.74 Typical High $616.60 | Professional | 62 · Two surgeons | $371.54 | $467.74 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $3,235.94 | Facility | None | $741.31 | $741.31 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $3,467.37 | Facility | None | $645.65 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $4,677.35 | Professional | None | $676.08 | $870.96 | $4,677.35 |
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 $724.44 Median $1,047.13 Typical High $1,479.11 | Professional | None | $724.44 | $1,047.13 | $1,479.11 |
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 $575.44 Median $741.31 Typical High $1,348.96 | Professional | None | $575.44 | $741.31 | $1,348.96 |
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 $309.03 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $467.74 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $512.86 |
Where Indiana sits
The same service costs 6.6 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· 39th of 51
$759
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.