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 $977.24 Median $5,011.87 Typical High $11,220.18 | Facility | None | $977.24 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,122.02 | Professional | None | $891.25 | $977.24 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $14,454.40 Typical High $33,884.42 | Facility | None | $2,398.83 | $14,454.40 | $33,884.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $1,659.59 | Professional | None | $891.25 | $1,288.25 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,949.84 Typical High $2,570.40 | Professional | 50 · Both sides | $1,348.96 | $1,949.84 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $7,244.36 | Facility | None | $1,071.52 | $1,071.52 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,786.30 Typical High $7,943.28 | Facility | None | $645.65 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $6,025.60 | Professional | None | $1,023.29 | $1,258.93 | $6,025.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $7,585.78 Typical High $10,471.29 | Facility | None | $2,089.30 | $7,585.78 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,479.11 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,248.07 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,248.07 | $14,454.40 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,862.09 | Professional | None | $851.14 | $1,122.02 | $1,862.09 |
4 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 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $758.58 |
Where Indiana sits
The same service costs 7.6 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· 33rd of 51
$1,288
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.