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 $501.19 Median $5,011.87 Typical High $11,220.18 | Facility | None | $501.19 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $575.44 | Professional | None | $457.09 | $501.19 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $812.83 | Professional | None | $478.63 | $616.60 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $933.25 Typical High $1,230.27 | Professional | 50 · Both sides | $724.44 | $933.25 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $3,235.94 | Facility | None | $549.54 | $549.54 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $3,467.37 | Facility | None | $602.56 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $3,019.95 | Professional | None | $512.86 | $602.56 | $3,019.95 |
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 $575.44 Median $776.25 Typical High $1,096.48 | Professional | None | $575.44 | $776.25 | $1,096.48 |
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 $426.58 Median $562.34 Typical High $933.25 | Professional | None | $426.58 | $562.34 | $933.25 |
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 $229.09 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $229.09 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $346.74 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $45.71 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $389.05 |
Where Indiana sits
The same service costs 7.9 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· 36th of 51
$617
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.