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 $1,318.26 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,318.26 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,318.26 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,513.56 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,513.56 | Professional | None | $912.01 | $1,071.52 | $1,513.56 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $6,025.60 | Facility | None | $1,318.26 | $1,318.26 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,630.78 Typical High $6,456.54 | Facility | None | $912.01 | $3,630.78 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,412.54 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $6,309.57 Typical High $8,511.38 | Facility | None | $2,089.30 | $6,309.57 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,737.80 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,412.54 | $2,238.72 |
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 $630.96 Median $660.69 Typical High $758.58 | Professional | 52 · Reduced service | $630.96 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $251.19 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,148.15 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $190.55 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $151.36 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $1,071.52 |
Where Indiana sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 43rd of 51
$1,349
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.