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 $95.50 Median $3,801.89 Typical High $5,623.41 | Facility | None | $95.50 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $123.03 | Professional | None | $87.10 | $100.00 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $151.36 | Professional | None | $87.10 | $109.65 | $151.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $165.96 Typical High $229.09 | Professional | 50 · Both sides | $131.83 | $165.96 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $165.96 | Facility | None | $107.15 | $107.15 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $128.82 Typical High $218.78 | Facility | None | $66.07 | $128.82 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $245.47 | Professional | None | $104.71 | $134.90 | $245.47 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $169.82 Median $346.74 Typical High $954.99 | Facility | None | $169.82 | $346.74 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $239.88 | Professional | None | $117.49 | $165.96 | $239.88 |
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 $87.10 Median $109.65 Typical High $199.53 | Professional | None | $87.10 | $109.65 | $199.53 |
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 $47.86 Median $50.12 Typical High $56.23 | Professional | 52 · Reduced service | $47.86 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.95 Typical High $22.91 | Professional | 53 · Discontinued | $19.05 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $75.86 Typical High $85.11 | Professional | 54 · Surgery only | $72.44 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $14.45 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.00 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.55 | $10.00 | $11.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $70.79 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $67.61 | $70.79 | $79.43 |
Where Indiana sits
The same service costs 4.5 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· 45th of 51
$110
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.