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 $398.11 Median $5,011.87 Typical High $11,220.18 | Facility | None | $398.11 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $524.81 | Professional | None | $398.11 | $398.11 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $891.25 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $691.83 | Professional | None | $354.81 | $512.86 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $758.58 Typical High $1,047.13 | Professional | 50 · Both sides | $537.03 | $758.58 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $3,467.37 | Facility | None | $416.87 | $416.87 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,454.71 Typical High $3,715.35 | Facility | None | $630.96 | $2,454.71 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $831.76 | Professional | None | $389.05 | $501.19 | $831.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,071.52 Median $3,311.31 Typical High $5,011.87 | Facility | None | $1,071.52 | $3,311.31 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $776.25 | Professional | None | $426.58 | $512.86 | $776.25 |
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 $389.05 Median $478.63 Typical High $758.58 | Professional | None | $389.05 | $478.63 | $758.58 |
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 $199.53 Median $199.53 Typical High $239.88 | Professional | 52 · Reduced service | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | 53 · Discontinued | $81.28 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $47.86 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $331.13 |
Where Indiana sits
The same service costs 6.0 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· 42nd of 51
$513
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.