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 $407.38 Median $5,011.87 Typical High $7,244.36 | Facility | None | $407.38 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $501.19 | Professional | None | $371.54 | $407.38 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $7,079.46 Typical High $11,481.54 | Facility | None | $1,380.38 | $7,079.46 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $741.31 | Professional | None | $371.54 | $562.34 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $831.76 | Professional | None | $416.87 | $537.03 | $831.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,187.76 | Facility | None | $912.01 | $1,122.02 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | None | $446.68 | $549.54 | $794.33 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $794.33 | Professional | None | $398.11 | $512.86 | $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 $186.21 Median $204.17 Typical High $245.47 | Professional | 52 · Reduced service | $186.21 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $74.13 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $281.84 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $281.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $263.03 | $281.84 | $338.84 |
Where Indiana sits
The same service costs 7.2 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· 30th 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.