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 $1,380.38 Median $5,011.87 Typical High $11,220.18 | Facility | None | $1,380.38 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,548.82 | $1,949.84 |
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 $1,380.38 Median $2,089.30 Typical High $2,691.53 | Professional | None | $1,380.38 | $2,089.30 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $3,162.28 Typical High $4,168.69 | Professional | 50 · Both sides | $2,089.30 | $3,162.28 | $4,168.69 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $7,244.36 | Facility | None | $1,698.24 | $1,698.24 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,623.41 Typical High $7,943.28 | Facility | None | $645.65 | $5,623.41 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $9,772.37 | Professional | None | $1,621.81 | $1,995.26 | $9,772.37 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $4,466.84 Typical High $10,471.29 | Facility | None | $912.01 | $4,466.84 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $3,311.31 | Professional | None | $1,659.59 | $2,290.87 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,778.28 | $2,951.21 |
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 $1,071.52 Median $1,148.15 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $229.09 Typical High $257.04 | Professional | 55 · Aftercare only | $213.80 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $154.88 Typical High $169.82 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,202.26 |
Where Indiana sits
The same service costs 7.8 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
$2,089
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.