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 $446.68 Median $5,011.87 Typical High $5,623.41 | Facility | None | $446.68 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $446.68 Typical High $588.84 | Professional | None | $426.58 | $446.68 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $436.52 | Professional | None | $281.84 | $331.13 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $2,884.03 | Facility | None | $446.68 | $446.68 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,905.46 Typical High $3,235.94 | Facility | None | $407.38 | $1,905.46 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $831.76 | Professional | None | $371.54 | $478.63 | $831.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $977.24 Median $2,951.21 Typical High $4,677.35 | Facility | None | $977.24 | $2,951.21 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $794.33 | Professional | None | $478.63 | $630.96 | $794.33 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $707.95 | Professional | None | $363.08 | $446.68 | $707.95 |
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 $223.87 Typical High $281.84 | Professional | 52 · Reduced service | $213.80 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $89.13 Typical High $112.20 | Professional | 53 · Discontinued | $85.11 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $316.23 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $44.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $42.66 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $316.23 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $295.12 | $316.23 | $389.05 |
Where Indiana sits
The same service costs 6.2 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· 44th of 51
$427
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.