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 $288.40 Median $5,011.87 Typical High $7,244.36 | Facility | None | $288.40 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $436.52 | Professional | None | $288.40 | $363.08 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $489.78 | Professional | None | $251.19 | $354.81 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $524.81 Typical High $741.31 | Professional | 50 · Both sides | $407.38 | $524.81 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $549.54 | Facility | None | $316.23 | $316.23 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $562.34 Typical High $1,479.11 | Facility | None | $338.84 | $562.34 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $870.96 | Professional | None | $316.23 | $478.63 | $870.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $575.44 Median $912.01 Typical High $2,344.23 | Facility | None | $575.44 | $912.01 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $338.84 Median $575.44 Typical High $812.83 | Professional | None | $338.84 | $575.44 | $812.83 |
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 $269.15 Median $398.11 Typical High $676.08 | Professional | None | $269.15 | $398.11 | $676.08 |
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 $144.54 Median $177.83 Typical High $218.78 | Professional | 52 · Reduced service | $144.54 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $72.44 Typical High $87.10 | Professional | 53 · Discontinued | $57.54 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $213.80 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $43.65 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $36.31 Typical High $43.65 | Professional | 56 · Pre-op care only | $28.84 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $251.19 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $199.53 | $251.19 | $302.00 |
Where Indiana sits
The same service costs 4.5 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· 41st of 51
$398
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.