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 $331.13 Median $3,467.37 Typical High $7,244.36 | Facility | None | $331.13 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $575.44 | Professional | None | $331.13 | $467.74 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $363.08 | Professional | None | $218.78 | $257.04 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $380.19 Typical High $562.34 | Professional | 50 · Both sides | $323.59 | $380.19 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $2,344.23 | Facility | None | $363.08 | $363.08 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $2,511.89 | Facility | None | $549.54 | $1,737.80 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $954.99 | Professional | None | $338.84 | $512.86 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,862.09 Typical High $2,951.21 | Facility | None | $912.01 | $1,862.09 | $2,951.21 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $398.11 Median $707.95 Typical High $1,000.00 | Professional | None | $398.11 | $707.95 | $1,000.00 |
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 $281.84 Median $467.74 Typical High $851.14 | Professional | None | $281.84 | $467.74 | $851.14 |
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 $165.96 Median $234.42 Typical High $288.40 | Professional | 52 · Reduced service | $165.96 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $93.33 Typical High $114.82 | Professional | 53 · Discontinued | $66.07 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $346.74 Typical High $436.52 | Professional | 54 · Surgery only | $245.47 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $69.18 Typical High $87.10 | Professional | 55 · Aftercare only | $48.98 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $46.77 Typical High $57.54 | Professional | 56 · Pre-op care only | $33.11 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $323.59 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $229.09 | $323.59 | $407.38 |
Where Indiana sits
The same service costs 4.7 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· 45th of 51
$437
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.