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 $457.09 Median $3,548.13 Typical High $14,125.38 | Facility | None | $457.09 | $3,548.13 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $676.08 | Professional | None | $457.09 | $575.44 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $10,964.78 Typical High $22,908.68 | Facility | None | $1,380.38 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $794.33 | Professional | None | $389.05 | $588.84 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $6,025.60 | Facility | None | $467.74 | $467.74 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,890.45 Typical High $6,606.93 | Facility | None | $776.25 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $1,023.29 | Professional | None | $478.63 | $645.65 | $1,023.29 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,174.90 Median $5,128.61 Typical High $8,511.38 | Facility | None | $1,174.90 | $5,128.61 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,096.48 | Professional | None | $501.19 | $724.44 | $1,096.48 |
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 $467.74 Median $660.69 Typical High $1,023.29 | Professional | None | $467.74 | $660.69 | $1,023.29 |
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 $281.84 Typical High $338.84 | Professional | 52 · Reduced service | $229.09 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $112.20 Typical High $134.90 | Professional | 53 · Discontinued | $91.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $426.58 Typical High $512.86 | Professional | 54 · Surgery only | $338.84 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $85.11 Typical High $102.33 | Professional | 55 · Aftercare only | $69.18 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $56.23 Typical High $67.61 | Professional | 56 · Pre-op care only | $45.71 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $398.11 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $316.23 | $398.11 | $478.63 |
Where Indiana sits
The same service costs 5.0 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· 39th of 51
$646
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.