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 $363.08 Median $3,467.37 Typical High $7,244.36 | Facility | None | $363.08 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $501.19 | Professional | None | $363.08 | $426.58 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $616.60 | Professional | None | $316.23 | $467.74 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $707.95 Typical High $933.25 | Professional | 50 · Both sides | $478.63 | $707.95 | $933.25 |
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 $416.87 Median $1,513.56 Typical High $2,630.27 | Facility | None | $416.87 | $1,513.56 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $676.08 | Professional | None | $302.00 | $446.68 | $676.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $3,890.45 | Facility | None | $954.99 | $2,238.72 | $3,890.45 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $794.33 | Professional | None | $446.68 | $616.60 | $794.33 |
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 $363.08 Median $457.09 Typical High $794.33 | Professional | None | $363.08 | $457.09 | $794.33 |
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 $181.97 Median $208.93 Typical High $251.19 | Professional | 52 · Reduced service | $181.97 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $85.11 Typical High $100.00 | Professional | 53 · Discontinued | $72.44 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $316.23 Typical High $371.54 | Professional | 54 · Surgery only | $275.42 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $63.10 Typical High $74.13 | Professional | 55 · Aftercare only | $54.95 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $36.31 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $295.12 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $257.04 | $295.12 | $346.74 |
Where Indiana sits
The same service costs 6.0 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· 36th of 51
$468
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.