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 $501.19 Median $537.03 Typical High $14,125.38 | Facility | None | $501.19 | $537.03 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $588.84 | Professional | None | $446.68 | $446.68 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $9,549.93 | Facility | None | $1,174.90 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $724.44 | Professional | None | $389.05 | $537.03 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $812.83 Typical High $1,122.02 | Professional | 50 · Both sides | $588.84 | $812.83 | $1,122.02 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $3,467.37 | Facility | None | $467.74 | $467.74 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,089.30 Typical High $3,630.78 | Facility | None | $562.34 | $2,089.30 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $794.33 | Professional | None | $407.38 | $562.34 | $794.33 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,174.90 Median $3,548.13 Typical High $5,011.87 | Facility | None | $1,174.90 | $3,548.13 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $870.96 | Professional | None | $467.74 | $575.44 | $870.96 |
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 $426.58 Median $537.03 Typical High $831.76 | Professional | None | $426.58 | $537.03 | $831.76 |
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 $223.87 Median $223.87 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $331.13 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $371.54 |
Where Indiana sits
The same service costs 8.7 times more in Oklahoma 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· 43rd of 51
$562
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.