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 $169.82 Median $3,467.37 Typical High $11,220.18 | Facility | None | $169.82 | $3,467.37 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $316.23 | Professional | None | $158.49 | $263.03 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,122.02 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $331.13 | Professional | None | $154.88 | $245.47 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $363.08 Typical High $489.78 | Professional | 50 · Both sides | $229.09 | $363.08 | $489.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $100.00 Median $154.88 Typical High $208.93 | Professional | 62 · Two surgeons | $100.00 | $154.88 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $7,244.36 | Facility | None | $186.21 | $186.21 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $3,467.37 Typical High $9,772.37 | Facility | None | $281.84 | $3,467.37 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $346.74 Typical High $676.08 | Professional | None | $190.55 | $346.74 | $676.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $891.25 Median $2,290.87 Typical High $10,471.29 | Facility | None | $891.25 | $2,290.87 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $223.87 Median $380.19 Typical High $645.65 | Professional | None | $223.87 | $380.19 | $645.65 |
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 $158.49 Median $295.12 Typical High $524.81 | Professional | None | $158.49 | $295.12 | $524.81 |
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 $85.11 Median $131.83 Typical High $158.49 | Professional | 52 · Reduced service | $85.11 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $52.48 Typical High $63.10 | Professional | 53 · Discontinued | $33.88 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $128.82 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $38.90 Typical High $46.77 | Professional | 55 · Aftercare only | $25.70 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $26.30 Typical High $31.62 | Professional | 56 · Pre-op care only | $16.98 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $181.97 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $120.23 | $181.97 | $218.78 |
Where Indiana sits
The same service costs 5.1 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· 44th of 51
$282
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.