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 $537.03 Median $5,011.87 Typical High $14,125.38 | Facility | None | $537.03 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | None | $537.03 | $537.03 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $9,549.93 | Facility | None | $1,174.90 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $851.14 | Professional | None | $467.74 | $630.96 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $954.99 Typical High $1,258.93 | Professional | 50 · Both sides | $707.95 | $954.99 | $1,258.93 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $2,137.96 | Facility | None | $562.34 | $562.34 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,659.59 Typical High $3,090.30 | Facility | None | $724.44 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $912.01 | Professional | None | $398.11 | $602.56 | $912.01 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $3,388.44 | Facility | None | $912.01 | $2,187.76 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,047.13 | Professional | None | $630.96 | $851.14 | $1,047.13 |
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 $467.74 Median $602.56 Typical High $1,000.00 | Professional | None | $467.74 | $602.56 | $1,000.00 |
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 $269.15 Median $269.15 Typical High $316.23 | Professional | 52 · Reduced service | $269.15 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | 53 · Discontinued | $107.15 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | 54 · Surgery only | $398.11 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $446.68 |
Where Indiana sits
The same service costs 8.5 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· 37th of 51
$631
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.