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 $346.74 Median $3,548.13 Typical High $14,125.38 | Facility | None | $346.74 | $3,548.13 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $501.19 | Professional | None | $323.59 | $416.87 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $9,549.93 | Facility | None | $1,174.90 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $575.44 | Professional | None | $302.00 | $426.58 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $645.65 Typical High $870.96 | Professional | 50 · Both sides | $457.09 | $645.65 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $1,479.11 | Facility | None | $371.54 | $371.54 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,174.90 Typical High $2,238.72 | Facility | None | $741.31 | $1,174.90 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $1,023.29 | Professional | None | $380.19 | $549.54 | $1,023.29 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $2,344.23 | Facility | None | $912.01 | $1,445.44 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $398.11 Median $676.08 Typical High $933.25 | Professional | None | $398.11 | $676.08 | $933.25 |
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 $467.74 Typical High $812.83 | Professional | None | $323.59 | $467.74 | $812.83 |
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 $173.78 Median $208.93 Typical High $251.19 | Professional | 52 · Reduced service | $173.78 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $69.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $316.23 Typical High $380.19 | Professional | 54 · Surgery only | $257.04 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $63.10 Typical High $75.86 | Professional | 55 · Aftercare only | $52.48 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $34.67 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $295.12 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $239.88 | $295.12 | $354.81 |
Where Indiana sits
The same service costs 4.8 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· 42nd of 51
$468
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.