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 $436.52 Median $5,011.87 Typical High $11,220.18 | Facility | None | $436.52 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $1,122.02 Typical High $1,445.44 | Professional | None | $426.58 | $1,122.02 | $1,445.44 |
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 $363.08 Median $1,023.29 Typical High $2,041.74 | Professional | None | $363.08 | $1,023.29 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $1,548.82 Typical High $3,090.30 | Professional | 50 · Both sides | $549.54 | $1,548.82 | $3,090.30 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $3,311.31 | Facility | None | $389.05 | $389.05 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $3,467.37 | Facility | None | $512.86 | $2,089.30 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $870.96 Typical High $2,187.76 | Professional | None | $389.05 | $870.96 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,000.00 | $3,467.37 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $467.74 Median $776.25 Typical High $1,995.26 | Professional | None | $467.74 | $776.25 | $1,995.26 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,023.29 Typical High $2,187.76 | Professional | None | $380.19 | $1,023.29 | $2,187.76 |
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 $213.80 Median $562.34 Typical High $724.44 | Professional | 52 · Reduced service | $213.80 | $562.34 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $223.87 Typical High $288.40 | Professional | 53 · Discontinued | $87.10 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $851.14 Typical High $1,096.48 | Professional | 54 · Surgery only | $323.59 | $851.14 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $169.82 Typical High $218.78 | Professional | 55 · Aftercare only | $64.57 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $112.20 Typical High $144.54 | Professional | 56 · Pre-op care only | $43.65 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $794.33 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $302.00 | $794.33 | $1,023.29 |
Where Indiana sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 27th 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.