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 $323.59 Median $512.86 Typical High $5,248.07 | Facility | None | $323.59 | $512.86 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $426.58 | Professional | None | $251.19 | $331.13 | $426.58 |
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 $257.04 Median $346.74 Typical High $467.74 | Professional | None | $257.04 | $346.74 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $512.86 Typical High $691.83 | Professional | 50 · Both sides | $380.19 | $512.86 | $691.83 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $549.54 | Facility | None | $295.12 | $295.12 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $524.81 Typical High $1,202.26 | Facility | None | $316.23 | $524.81 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $741.31 | Professional | None | $309.03 | $457.09 | $741.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $512.86 Median $912.01 Typical High $2,344.23 | Facility | None | $512.86 | $912.01 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $831.76 | Professional | None | $316.23 | $562.34 | $831.76 |
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 $251.19 Median $380.19 Typical High $660.69 | Professional | None | $251.19 | $380.19 | $660.69 |
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 $134.90 Median $173.78 Typical High $208.93 | Professional | 52 · Reduced service | $134.90 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $69.18 Typical High $83.18 | Professional | 53 · Discontinued | $53.70 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $204.17 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $40.74 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $34.67 Typical High $41.69 | Professional | 56 · Pre-op care only | $26.92 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $190.55 | $239.88 | $295.12 |
Where Indiana sits
The same service costs 4.7 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· 40th of 51
$380
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.