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 $446.68 Median $5,011.87 Typical High $7,244.36 | Facility | None | $446.68 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $537.03 | Professional | None | $407.38 | $446.68 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $691.83 | Professional | None | $380.19 | $512.86 | $691.83 |
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 $549.54 Median $2,238.72 Typical High $3,801.89 | Facility | None | $549.54 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $776.25 | Professional | None | $416.87 | $512.86 | $776.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,148.15 Median $3,548.13 Typical High $4,570.88 | Facility | None | $1,148.15 | $3,548.13 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $831.76 | Professional | None | $457.09 | $562.34 | $831.76 |
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 $407.38 Median $501.19 Typical High $794.33 | Professional | None | $407.38 | $501.19 | $794.33 |
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 $204.17 Median $223.87 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $91.20 Typical High $107.15 | Professional | 53 · Discontinued | $81.28 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $309.03 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $288.40 | $316.23 | $371.54 |
Where Indiana sits
The same service costs 8.9 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· 41st 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.