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 $977.24 Median $5,011.87 Typical High $7,244.36 | Facility | None | $977.24 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,202.26 | Professional | None | $977.24 | $977.24 | $1,202.26 |
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 $912.01 Median $1,122.02 Typical High $1,479.11 | Professional | None | $912.01 | $1,122.02 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,905.46 | Facility | None | $1,122.02 | $1,122.02 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,479.11 Typical High $2,454.71 | Facility | None | $794.33 | $1,479.11 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $5,248.07 | Professional | None | $776.25 | $1,202.26 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,071.52 Median $2,238.72 Typical High $3,090.30 | Facility | None | $1,071.52 | $2,238.72 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,000.00 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,479.11 | $2,089.30 |
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 $812.83 Median $1,000.00 Typical High $1,778.28 | Professional | None | $812.83 | $1,000.00 | $1,778.28 |
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 $489.78 Median $489.78 Typical High $602.56 | Professional | 52 · Reduced service | $489.78 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $239.88 | Professional | 53 · Discontinued | $194.98 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $912.01 | Professional | 54 · Surgery only | $724.44 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $851.14 |
Where Indiana sits
The same service costs 5.9 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· 40th of 51
$1,122
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.