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 $354.81 Median $5,011.87 Typical High $7,244.36 | Facility | None | $354.81 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $1,230.27 Typical High $1,380.38 | Professional | None | $354.81 | $1,230.27 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,288.25 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $1,258.93 Typical High $3,235.94 | Professional | None | $602.56 | $1,258.93 | $3,235.94 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $2,238.72 | Facility | None | $389.05 | $389.05 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,819.70 Typical High $2,691.53 | Facility | None | $630.96 | $1,819.70 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $1,230.27 Typical High $3,890.45 | Professional | None | $446.68 | $1,230.27 | $3,890.45 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,000.00 Median $2,691.53 Typical High $5,888.44 | Facility | None | $1,000.00 | $2,691.53 | $5,888.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $478.63 Median $977.24 Typical High $2,398.83 | Professional | None | $478.63 | $977.24 | $2,398.83 |
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 $416.87 Median $1,202.26 Typical High $3,467.37 | Professional | None | $416.87 | $1,202.26 | $3,467.37 |
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 $177.83 Median $616.60 Typical High $691.83 | Professional | 52 · Reduced service | $177.83 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $245.47 Typical High $275.42 | Professional | 53 · Discontinued | $70.79 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $912.01 Typical High $1,023.29 | Professional | 54 · Surgery only | $269.15 | $912.01 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $181.97 Typical High $204.17 | Professional | 55 · Aftercare only | $53.70 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $123.03 Typical High $138.04 | Professional | 56 · Pre-op care only | $35.48 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $851.14 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $251.19 | $851.14 | $954.99 |
Where Indiana sits
The same service costs 4.9 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· 35th of 51
$1,380
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.