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 $354.81 Median $549.54 Typical High $5,011.87 | Facility | None | $354.81 | $549.54 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $478.63 | Professional | None | $275.42 | $363.08 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $501.19 | Professional | None | $257.04 | $363.08 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $549.54 Typical High $741.31 | Professional | 50 · Both sides | $389.05 | $549.54 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $1,479.11 | Facility | None | $316.23 | $316.23 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,096.48 Typical High $2,089.30 | Facility | None | $549.54 | $1,096.48 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $912.01 | Professional | None | $323.59 | $489.78 | $912.01 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,318.26 Typical High $2,344.23 | Facility | None | $912.01 | $1,318.26 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $346.74 Median $588.84 Typical High $812.83 | Professional | None | $346.74 | $588.84 | $812.83 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $707.95 | Professional | None | $275.42 | $416.87 | $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 $147.91 Median $181.97 Typical High $223.87 | Professional | 52 · Reduced service | $147.91 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $74.13 Typical High $89.13 | Professional | 53 · Discontinued | $58.88 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $275.42 Typical High $331.13 | Professional | 54 · Surgery only | $218.78 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $54.95 Typical High $66.07 | Professional | 55 · Aftercare only | $43.65 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $37.15 Typical High $44.67 | Professional | 56 · Pre-op care only | $29.51 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $257.04 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $204.17 | $257.04 | $309.03 |
Where Indiana sits
The same service costs 4.9 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· 41st of 51
$417
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.