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 $812.83 Median $5,011.87 Typical High $14,125.38 | Facility | None | $812.83 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,096.48 | Professional | None | $776.25 | $812.83 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $10,964.78 Typical High $22,908.68 | Facility | None | $1,380.38 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,122.02 | Professional | None | $676.08 | $977.24 | $1,122.02 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $6,025.60 | Facility | None | $831.76 | $831.76 | $6,025.60 |
CareSource Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,311.31 Typical High $6,309.57 | Facility | None | $794.33 | $3,311.31 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,621.81 | Professional | None | $776.25 | $977.24 | $1,621.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,041.74 Median $6,165.95 Typical High $8,511.38 | Facility | None | $2,041.74 | $6,165.95 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,445.44 | Professional | None | $831.76 | $1,148.15 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,348.96 | Professional | None | $707.95 | $891.25 | $1,348.96 |
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 $389.05 Median $407.38 Typical High $537.03 | Professional | 52 · Reduced service | $389.05 | $407.38 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $213.80 | Professional | 53 · Discontinued | $158.49 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $602.56 Typical High $794.33 | Professional | 54 · Surgery only | $588.84 | $602.56 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $162.18 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $107.15 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $562.34 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $549.54 | $562.34 | $741.31 |
Where Indiana sits
The same service costs 6.5 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· 33rd of 51
$955
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.