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 $141.25 Median $2,344.23 Typical High $5,623.41 | Facility | None | $141.25 | $2,344.23 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $177.83 | Professional | None | $141.25 | $154.88 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $6,165.95 | Facility | None | $616.60 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $177.83 | Professional | None | $107.15 | $125.89 | $177.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $190.55 Typical High $269.15 | Professional | 50 · Both sides | $158.49 | $190.55 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $251.19 | Facility | None | $154.88 | $154.88 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $208.93 Typical High $354.81 | Facility | None | $66.07 | $208.93 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $346.74 | Professional | None | $151.36 | $181.97 | $346.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $436.52 Typical High $954.99 | Facility | None | $229.09 | $436.52 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $354.81 | Professional | None | $173.78 | $251.19 | $354.81 |
United Setting Facility Modifier None Typical Low $109.65 Median $851.14 Typical High $4,168.69 | Facility | None | $109.65 | $851.14 | $4,168.69 |
United Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $288.40 | Professional | None | $128.82 | $165.96 | $288.40 |
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 $70.79 Median $77.62 Typical High $87.10 | Professional | 52 · Reduced service | $70.79 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $30.90 Typical High $35.48 | Professional | 53 · Discontinued | $28.18 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $114.82 Typical High $131.83 | Professional | 54 · Surgery only | $104.71 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.91 Typical High $26.30 | Professional | 55 · Aftercare only | $21.38 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.13 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $107.15 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $97.72 | $107.15 | $123.03 |
Where Indiana sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$170
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.