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 $812.83 Median $5,011.87 Typical High $7,244.36 | Facility | None | $812.83 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Professional | None | $812.83 | $812.83 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,413.10 Typical High $17,378.01 | Facility | None | $758.58 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $851.14 | Professional | None | $512.86 | $602.56 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $912.01 Typical High $1,348.96 | Professional | 50 · Both sides | $758.58 | $912.01 | $1,348.96 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $3,311.31 | Facility | None | $831.76 | $831.76 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,995.26 Typical High $3,630.78 | Facility | None | $562.34 | $1,995.26 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $870.96 Typical High $1,258.93 | Professional | None | $524.81 | $870.96 | $1,258.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,412.54 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,412.54 | $3,388.44 | $5,495.41 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,548.82 | Professional | None | $933.25 | $1,258.93 | $1,548.82 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,412.54 | Professional | None | $645.65 | $851.14 | $1,412.54 |
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 $407.38 Median $407.38 Typical High $478.63 | Professional | 52 · Reduced service | $407.38 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | 53 · Discontinued | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $676.08 |
Where Indiana sits
The same service costs 8.3 times more in Wyoming 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
$851
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.