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 $363.08 Median $5,011.87 Typical High $11,220.18 | Facility | None | $363.08 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $416.87 | Professional | None | $331.13 | $363.08 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,047.13 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $524.81 | Professional | None | $309.03 | $380.19 | $524.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $575.44 Typical High $812.83 | Professional | 50 · Both sides | $457.09 | $575.44 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $7,244.36 | Facility | None | $398.11 | $398.11 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $4,168.69 Typical High $7,762.47 | Facility | None | $489.78 | $4,168.69 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $3,801.89 | Professional | None | $389.05 | $489.78 | $3,801.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,235.94 Typical High $10,471.29 | Facility | None | $912.01 | $3,235.94 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $812.83 | Professional | None | $371.54 | $575.44 | $812.83 |
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 $309.03 Median $389.05 Typical High $676.08 | Professional | None | $309.03 | $389.05 | $676.08 |
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 $181.97 Typical High $199.53 | Professional | 52 · Reduced service | $165.96 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $72.44 Typical High $79.43 | Professional | 53 · Discontinued | $67.61 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $269.15 Typical High $295.12 | Professional | 54 · Surgery only | $251.19 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $58.88 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $251.19 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $234.42 | $251.19 | $275.42 |
Where Indiana sits
The same service costs 7.2 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· 43rd of 51
$398
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.