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 $588.84 Median $5,011.87 Typical High $11,220.18 | Facility | None | $588.84 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $676.08 | Professional | None | $549.54 | $588.84 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $7,413.10 Typical High $15,135.61 | Facility | None | $1,096.48 | $7,413.10 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $977.24 | Professional | None | $549.54 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,122.02 Typical High $1,513.56 | Professional | 50 · Both sides | $831.76 | $1,122.02 | $1,513.56 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $3,235.94 | Facility | None | $660.69 | $660.69 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,995.26 Typical High $3,467.37 | Facility | None | $630.96 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $3,981.07 | Professional | None | $602.56 | $724.44 | $3,981.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $4,677.35 | Facility | None | $912.01 | $2,454.71 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,258.93 | Professional | None | $602.56 | $891.25 | $1,258.93 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,466.84 Typical High $9,120.11 | Facility | None | $870.96 | $4,466.84 | $9,120.11 |
United Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,122.02 | Professional | None | $512.86 | $660.69 | $1,122.02 |
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 $269.15 Median $295.12 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $489.78 | Professional | 54 · Surgery only | $407.38 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $457.09 |
Where Indiana sits
The same service costs 7.4 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· 34th of 51
$741
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.