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 $933.25 Median $5,011.87 Typical High $7,244.36 | Facility | None | $933.25 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,230.27 | Professional | None | $954.99 | $954.99 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,548.82 | Professional | None | $851.14 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $724.44 Typical High $977.24 | Professional | 62 · Two surgeons | $537.03 | $724.44 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,230.27 | Facility | None | $831.76 | $1,047.13 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $2,691.53 | Facility | None | $630.96 | $1,548.82 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,995.26 | Professional | None | $954.99 | $1,258.93 | $1,995.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $2,290.87 Typical High $2,951.21 | Facility | None | $954.99 | $2,290.87 | $2,951.21 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,548.82 | $1,905.46 |
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 $912.01 Median $1,202.26 Typical High $1,905.46 | Professional | None | $912.01 | $1,202.26 | $1,905.46 |
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 $467.74 Median $467.74 Typical High $616.60 | Professional | 52 · Reduced service | $467.74 | $467.74 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $245.47 | Professional | 53 · Discontinued | $190.55 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $933.25 | Professional | 54 · Surgery only | $707.95 | $707.95 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $186.21 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $870.96 |
Where Indiana sits
The same service costs 5.9 times more in Alaska than in Utah. 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
$1,148
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.