How much rates vary
Facilitymedian $1,950 · 10th to 90th $339 to $5,129Professionalmedian $339 · 10th to 90th $219 to $490
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 $218.78 Median $3,801.89 Typical High $5,623.41 | Facility | None | $218.78 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $380.19 | Professional | None | $218.78 | $281.84 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $281.84 | Professional | None | $190.55 | $190.55 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $3,235.94 Typical High $6,165.95 | Facility | None | $676.08 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $416.87 Typical High $501.19 | Professional | None | $190.55 | $416.87 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $630.96 Typical High $758.58 | Professional | 50 · Both sides | $288.40 | $630.96 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $371.54 | Facility | None | $234.42 | $234.42 | $371.54 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $309.03 | Professional | None | $263.03 | $269.15 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $380.19 Typical High $724.44 | Facility | None | $234.42 | $380.19 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $467.74 | Professional | None | $223.87 | $309.03 | $467.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $295.12 Median $575.44 Typical High $1,023.29 | Facility | None | $295.12 | $575.44 | $1,023.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $537.03 | Professional | None | $269.15 | $407.38 | $537.03 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $602.56 | Professional | None | $234.42 | $338.84 | $602.56 |
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 $109.65 Median $141.25 Typical High $165.96 | Professional | 52 · Reduced service | $109.65 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $56.23 Typical High $66.07 | Professional | 53 · Discontinued | $43.65 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $208.93 Typical High $245.47 | Professional | 54 · Surgery only | $165.96 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $41.69 Typical High $50.12 | Professional | 55 · Aftercare only | $33.11 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $28.18 Typical High $33.11 | Professional | 56 · Pre-op care only | $21.88 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $194.98 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $154.88 | $194.98 | $229.09 |
Where Indiana sits
The same service costs 4.2 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· 23rd of 51
$380
AK $955UT $229
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.