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 $331.13 Median $3,467.37 Typical High $7,244.36 | Facility | None | $331.13 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $467.74 | Professional | None | $331.13 | $363.08 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $3,235.94 Typical High $6,165.95 | Facility | None | $630.96 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $524.81 | Professional | None | $288.40 | $407.38 | $524.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $616.60 Typical High $812.83 | Professional | 50 · Both sides | $436.52 | $616.60 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $616.60 | Facility | None | $346.74 | $346.74 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $562.34 Typical High $1,000.00 | Facility | None | $363.08 | $562.34 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $630.96 | Professional | None | $263.03 | $363.08 | $630.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $398.11 Median $794.33 Typical High $1,202.26 | Facility | None | $398.11 | $794.33 | $1,202.26 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $707.95 | Professional | None | $407.38 | $549.54 | $707.95 |
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 $316.23 Median $407.38 Typical High $691.83 | Professional | None | $316.23 | $407.38 | $691.83 |
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 $165.96 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $165.96 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $66.07 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $245.47 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $257.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $229.09 | $257.04 | $302.00 |
Where Indiana sits
The same service costs 5.6 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· 34th of 51
$407
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.