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 $323.59 Median $3,467.37 Typical High $7,244.36 | Facility | None | $323.59 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $489.78 | Professional | None | $323.59 | $426.58 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $10,964.78 Typical High $22,908.68 | Facility | None | $758.58 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $630.96 | Professional | None | $323.59 | $524.81 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $6,025.60 | Facility | None | $331.13 | $331.13 | $6,025.60 |
CareSource Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,890.45 Typical High $6,606.93 | Facility | None | $549.54 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $758.58 | Professional | None | $346.74 | $436.52 | $758.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,128.61 Typical High $8,511.38 | Facility | None | $912.01 | $5,128.61 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $758.58 | Professional | None | $371.54 | $562.34 | $758.58 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $676.08 | Professional | None | $323.59 | $436.52 | $676.08 |
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 $162.18 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $162.18 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $64.57 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $323.59 Typical High $346.74 | Professional | 54 · Surgery only | $245.47 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $48.98 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $32.36 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $302.00 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $229.09 | $302.00 | $323.59 |
Where Indiana sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 30th of 51
$468
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.