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 $104.71 Median $3,467.37 Typical High $5,623.41 | Facility | None | $104.71 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $194.98 | Professional | None | $104.71 | $165.96 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $186.21 | Professional | None | $91.20 | $141.25 | $186.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $208.93 Typical High $275.42 | Professional | 50 · Both sides | $138.04 | $208.93 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $1,445.44 Typical High $2,630.27 | Facility | None | $120.23 | $1,445.44 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $234.42 | Professional | None | $85.11 | $128.82 | $234.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $302.00 Median $2,187.76 Typical High $3,311.31 | Facility | None | $302.00 | $2,187.76 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $302.00 | Professional | None | $128.82 | $208.93 | $302.00 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $275.42 | Professional | None | $104.71 | $162.18 | $275.42 |
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 $51.29 Median $83.18 Typical High $97.72 | Professional | 52 · Reduced service | $51.29 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $33.11 Typical High $38.90 | Professional | 53 · Discontinued | $20.89 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $123.03 Typical High $147.91 | Professional | 54 · Surgery only | $77.62 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $25.12 Typical High $29.51 | Professional | 55 · Aftercare only | $15.49 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $16.60 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.47 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $114.82 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $72.44 | $114.82 | $138.04 |
Where Indiana sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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
$166
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.