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 $7,244.36 | Facility | None | $549.54 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $707.95 | Professional | None | $467.74 | $616.60 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $2,884.03 | Facility | None | $575.44 | $575.44 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,041.74 Typical High $3,090.30 | Facility | None | $549.54 | $2,041.74 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $1,096.48 | Professional | None | $501.19 | $588.84 | $1,096.48 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,445.44 Median $3,019.95 Typical High $3,981.07 | Facility | None | $1,445.44 | $3,019.95 | $3,981.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,000.00 | Professional | None | $630.96 | $794.33 | $1,000.00 |
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 $457.09 Median $549.54 Typical High $870.96 | Professional | None | $457.09 | $549.54 | $870.96 |
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 $275.42 Median $275.42 Typical High $371.54 | Professional | 52 · Reduced service | $275.42 | $275.42 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $151.36 | Professional | 53 · Discontinued | $109.65 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | 54 · Surgery only | $407.38 | $407.38 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $524.81 |
Where Indiana sits
The same service costs 5.5 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· 37th of 51
$603
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.