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 $363.08 Median $5,011.87 Typical High $11,220.18 | Facility | None | $363.08 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $436.52 | Professional | None | $323.59 | $363.08 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $10,232.93 Typical High $28,840.32 | Facility | None | $1,584.89 | $10,232.93 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $630.96 | Professional | None | $309.03 | $467.74 | $630.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $194.98 Median $295.12 Typical High $398.11 | Professional | 62 · Two surgeons | $194.98 | $295.12 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $5,888.44 | Facility | None | $380.19 | $380.19 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,890.45 Typical High $6,606.93 | Facility | None | $630.96 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $645.65 | Professional | None | $380.19 | $457.09 | $645.65 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $933.25 Median $4,466.84 Typical High $9,772.37 | Facility | None | $933.25 | $4,466.84 | $9,772.37 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $676.08 | Professional | None | $371.54 | $457.09 | $676.08 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $660.69 | Professional | None | $346.74 | $426.58 | $660.69 |
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 $165.96 Median $181.97 Typical High $218.78 | Professional | 52 · Reduced service | $165.96 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $87.10 | Professional | 53 · Discontinued | $66.07 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $66.07 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $234.42 | $257.04 | $302.00 |
Where Indiana sits
The same service costs 9.3 times more in Kansas 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
$468
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.