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 $371.54 Median $3,467.37 Typical High $11,220.18 | Facility | None | $371.54 | $3,467.37 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,258.93 Typical High $1,698.24 | Professional | None | $371.54 | $1,258.93 | $1,698.24 |
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 $316.23 Median $1,023.29 Typical High $2,630.27 | Professional | None | $316.23 | $1,023.29 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $1,412.54 Typical High $3,981.07 | Professional | 50 · Both sides | $478.63 | $1,412.54 | $3,981.07 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $3,311.31 | Facility | None | $338.84 | $338.84 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,398.83 Typical High $3,548.13 | Facility | None | $630.96 | $2,398.83 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $794.33 Typical High $2,398.83 | Professional | None | $338.84 | $794.33 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,630.78 Typical High $5,011.87 | Facility | None | $912.01 | $3,630.78 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $407.38 Median $676.08 Typical High $2,344.23 | Professional | None | $407.38 | $676.08 | $2,344.23 |
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 $331.13 Median $1,000.00 Typical High $2,344.23 | Professional | None | $331.13 | $1,000.00 | $2,344.23 |
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 $181.97 Median $616.60 Typical High $851.14 | Professional | 52 · Reduced service | $181.97 | $616.60 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $251.19 Typical High $338.84 | Professional | 53 · Discontinued | $74.13 | $251.19 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $933.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $275.42 | $933.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $186.21 Typical High $257.04 | Professional | 55 · Aftercare only | $54.95 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $125.89 Typical High $169.82 | Professional | 56 · Pre-op care only | $37.15 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $870.96 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $257.04 | $870.96 | $1,202.26 |
Where Indiana sits
The same service costs 5.8 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· 22nd of 51
$1,549
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.