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 $457.09 Median $3,548.13 Typical High $14,125.38 | Facility | None | $457.09 | $3,548.13 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $630.96 | Professional | None | $457.09 | $537.03 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,230.27 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $870.96 | Professional | None | $426.58 | $691.83 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $3,235.94 | Facility | None | $501.19 | $501.19 | $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 $512.86 Median $724.44 Typical High $1,230.27 | Professional | None | $512.86 | $724.44 | $1,230.27 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $4,677.35 | Facility | None | $912.01 | $2,290.87 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,230.27 | Professional | None | $549.54 | $851.14 | $1,230.27 |
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 $436.52 Median $630.96 Typical High $1,071.52 | Professional | None | $436.52 | $630.96 | $1,071.52 |
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 $229.09 Median $269.15 Typical High $316.23 | Professional | 52 · Reduced service | $229.09 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $107.15 Typical High $125.89 | Professional | 53 · Discontinued | $93.33 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $398.11 Typical High $478.63 | Professional | 54 · Surgery only | $346.74 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $81.28 Typical High $95.50 | Professional | 55 · Aftercare only | $69.18 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $53.70 Typical High $63.10 | Professional | 56 · Pre-op care only | $45.71 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $371.54 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $323.59 | $371.54 | $446.68 |
Where Indiana sits
The same service costs 5.8 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· 35th of 51
$692
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.