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 $776.25 Median $5,011.87 Typical High $11,220.18 | Facility | None | $776.25 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,047.13 | Professional | None | $776.25 | $776.25 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $10,964.78 Typical High $22,908.68 | Facility | None | $1,122.02 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,148.15 Typical High $1,548.82 | Professional | None | $707.95 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $724.44 Typical High $977.24 | Professional | 62 · Two surgeons | $446.68 | $724.44 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $5,248.07 | Facility | None | $851.14 | $851.14 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,548.13 Typical High $5,888.44 | Facility | None | $630.96 | $3,548.13 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,737.80 | Professional | None | $812.83 | $1,047.13 | $1,737.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,659.59 Median $5,370.32 Typical High $7,413.10 | Facility | None | $1,659.59 | $5,370.32 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,584.89 | Professional | None | $870.96 | $1,288.25 | $1,584.89 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,584.89 | Professional | None | $758.58 | $1,000.00 | $1,584.89 |
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 $389.05 Typical High $524.81 | Professional | 52 · Reduced service | $389.05 | $389.05 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $208.93 | Professional | 53 · Discontinued | $158.49 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $776.25 | Professional | 54 · Surgery only | $588.84 | $588.84 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $104.71 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $724.44 |
Where Indiana sits
The same service costs 5.9 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· 32nd 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.