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 $5,623.41 | Facility | None | $354.81 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $407.38 | Professional | None | $316.23 | $354.81 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $478.63 | Professional | None | $275.42 | $346.74 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $3,467.37 | Facility | None | $354.81 | $354.81 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $2,238.72 Typical High $3,801.89 | Facility | None | $407.38 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $588.84 | Professional | None | $263.03 | $363.08 | $588.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,548.13 Typical High $4,570.88 | Facility | None | $912.01 | $3,548.13 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $645.65 | Professional | None | $354.81 | $436.52 | $645.65 |
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 $275.42 Median $363.08 Typical High $602.56 | Professional | None | $275.42 | $363.08 | $602.56 |
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 $154.88 Median $177.83 Typical High $199.53 | Professional | 52 · Reduced service | $154.88 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $70.79 Typical High $79.43 | Professional | 53 · Discontinued | $63.10 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $263.03 Typical High $295.12 | Professional | 54 · Surgery only | $234.42 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $52.48 Typical High $60.26 | Professional | 55 · Aftercare only | $46.77 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $35.48 Typical High $39.81 | Professional | 56 · Pre-op care only | $31.62 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $245.47 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $218.78 | $245.47 | $275.42 |
Where Indiana sits
The same service costs 8.5 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· 45th of 51
$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.