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 $549.54 Median $5,011.87 Typical High $14,125.38 | Facility | None | $549.54 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $660.69 | Professional | None | $489.78 | $549.54 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $812.83 | Professional | None | $436.52 | $575.44 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $4,677.35 | Facility | None | $489.78 | $489.78 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,818.38 Typical High $4,897.79 | Facility | None | $630.96 | $2,818.38 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $891.25 | Professional | None | $489.78 | $575.44 | $891.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,258.93 Median $4,570.88 Typical High $5,888.44 | Facility | None | $1,258.93 | $4,570.88 | $5,888.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $831.76 | Professional | None | $512.86 | $616.60 | $831.76 |
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 $446.68 Median $645.65 Typical High $933.25 | Professional | None | $446.68 | $645.65 | $933.25 |
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 $245.47 Median $269.15 Typical High $309.03 | Professional | 52 · Reduced service | $245.47 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $123.03 | Professional | 53 · Discontinued | $97.72 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $457.09 | Professional | 54 · Surgery only | $363.08 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $93.33 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $61.66 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $380.19 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $338.84 | $380.19 | $426.58 |
Where Indiana sits
The same service costs 5.4 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· 39th of 51
$741
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.