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 $1,174.90 Median $5,011.87 Typical High $11,220.18 | Facility | None | $1,174.90 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,174.90 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $20,892.96 Typical High $43,651.58 | Facility | None | $1,513.56 | $20,892.96 | $43,651.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,548.82 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,344.23 Typical High $3,090.30 | Professional | 50 · Both sides | $1,621.81 | $2,344.23 | $3,090.30 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $20,892.96 | Facility | None | $1,318.26 | $1,318.26 | $20,892.96 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $10,471.29 Typical High $19,498.45 | Facility | None | $676.08 | $10,471.29 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $7,244.36 | Professional | None | $1,202.26 | $1,445.44 | $7,244.36 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $7,585.78 Typical High $24,547.09 | Facility | None | $912.01 | $7,585.78 | $24,547.09 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,778.28 | $2,511.89 |
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 $1,023.29 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,380.38 | $2,238.72 |
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 $812.83 Median $891.25 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $891.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $177.83 Typical High $194.98 | Professional | 55 · Aftercare only | $162.18 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $912.01 |
Where Indiana sits
The same service costs 8.1 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· 33rd of 51
$1,549
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.