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 $1,548.82 Median $5,011.87 Typical High $17,782.79 | Facility | None | $1,548.82 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,548.82 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $11,481.54 Typical High $23,442.29 | Facility | None | $1,862.09 | $11,481.54 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,737.80 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,096.48 Typical High $1,513.56 | Professional | 62 · Two surgeons | $851.14 | $1,096.48 | $1,513.56 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $6,025.60 | Facility | None | $1,584.89 | $1,584.89 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $3,715.35 Typical High $6,760.83 | Facility | None | $1,584.89 | $3,715.35 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,778.28 | $2,818.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $6,165.95 Typical High $8,511.38 | Facility | None | $2,089.30 | $6,165.95 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,621.81 | $2,041.74 | $2,951.21 |
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 $1,380.38 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,380.38 | $1,778.28 | $2,691.53 |
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 $758.58 Median $776.25 Typical High $912.01 | Professional | 52 · Reduced service | $758.58 | $776.25 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $316.23 Typical High $363.08 | Professional | 53 · Discontinued | $309.03 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,174.90 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,148.15 | $1,174.90 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $234.42 Typical High $275.42 | Professional | 55 · Aftercare only | $229.09 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $181.97 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,096.48 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,096.48 | $1,288.25 |
Where Indiana sits
The same service costs 6.3 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· 42nd of 51
$1,778
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.