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 $1,445.44 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,445.44 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,445.44 | $1,445.44 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,479.11 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,380.38 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,258.93 Typical High $1,698.24 | Professional | 62 · Two surgeons | $870.96 | $1,258.93 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $6,456.54 | Facility | None | $1,659.59 | $1,659.59 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $6,165.95 | Facility | None | $1,000.00 | $3,311.31 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,412.54 | $1,949.84 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $5,495.41 Typical High $9,332.54 | Facility | None | $2,089.30 | $5,495.41 | $9,332.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,698.24 | $2,290.87 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,230.27 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,862.09 | $2,951.21 |
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 $724.44 Median $724.44 Typical High $912.01 | Professional | 52 · Reduced service | $724.44 | $724.44 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $363.08 | Professional | 53 · Discontinued | $288.40 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $218.78 Typical High $269.15 | Professional | 55 · Aftercare only | $213.80 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $181.97 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,258.93 |
Where Indiana sits
The same service costs 6.6 times more in Alaska than in Texas. 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· 36th of 51
$1,995
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.