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 $1,380.38 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,380.38 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,445.44 | $1,479.11 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $11,481.54 Typical High $23,442.29 | Facility | None | $1,412.54 | $11,481.54 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,380.38 | $1,949.84 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $6,025.60 | Facility | None | $1,513.56 | $1,513.56 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,981.07 Typical High $6,606.93 | Facility | None | $645.65 | $3,981.07 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,479.11 | $1,819.70 | $2,454.71 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $5,495.41 Typical High $8,511.38 | Facility | None | $954.99 | $5,495.41 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,513.56 | $1,949.84 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,230.27 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,737.80 | $2,630.27 |
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 $724.44 Median $741.31 Typical High $851.14 | Professional | 52 · Reduced service | $724.44 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $295.12 Typical High $338.84 | Professional | 53 · Discontinued | $288.40 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,096.48 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,071.52 | $1,096.48 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $218.78 Typical High $251.19 | Professional | 55 · Aftercare only | $213.80 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $147.91 Typical High $169.82 | Professional | 56 · Pre-op care only | $144.54 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,023.29 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,023.29 | $1,174.90 |
Where Indiana sits
The same service costs 7.1 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· 42nd of 51
$1,660
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.