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 $14,125.38 | Facility | None | $812.83 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,047.13 | Professional | None | $812.83 | $812.83 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $10,964.78 Typical High $22,908.68 | Facility | None | $1,380.38 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,148.15 | Professional | None | $724.44 | $851.14 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $1,698.24 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $4,365.16 | Facility | None | $870.96 | $870.96 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,630.27 Typical High $4,677.35 | Facility | None | $776.25 | $2,630.27 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,348.96 | Professional | None | $588.84 | $891.25 | $1,348.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,890.45 Typical High $6,309.57 | Facility | None | $954.99 | $3,890.45 | $6,309.57 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,584.89 | Professional | None | $954.99 | $1,258.93 | $1,584.89 |
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 $724.44 Median $933.25 Typical High $1,584.89 | Professional | None | $724.44 | $933.25 | $1,584.89 |
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 $194.98 | Professional | 53 · Discontinued | $162.18 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | 54 · Surgery only | $616.60 | $616.60 | $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 $97.72 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $676.08 |
Where Indiana sits
The same service costs 7.6 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· 37th of 51
$933
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.