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 $316.23 Median $3,801.89 Typical High $5,623.41 | Facility | None | $316.23 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $478.63 | Professional | None | $316.23 | $407.38 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $457.09 | Professional | None | $275.42 | $338.84 | $457.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $512.86 Typical High $691.83 | Professional | 50 · Both sides | $407.38 | $512.86 | $691.83 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $562.34 | Facility | None | $338.84 | $338.84 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $537.03 Typical High $977.24 | Facility | None | $323.59 | $537.03 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $616.60 | Professional | None | $234.42 | $346.74 | $616.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $446.68 Median $912.01 Typical High $3,388.44 | Facility | None | $446.68 | $912.01 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $794.33 | Professional | None | $398.11 | $588.84 | $794.33 |
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 $302.00 Median $416.87 Typical High $707.95 | Professional | None | $302.00 | $416.87 | $707.95 |
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 $158.49 Median $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $158.49 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $63.10 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $309.03 Typical High $363.08 | Professional | 54 · Surgery only | $239.88 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $47.86 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $31.62 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $288.40 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $223.87 | $288.40 | $338.84 |
Where Indiana sits
The same service costs 5.0 times more in Alaska 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· 38th of 51
$407
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.