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 $257.04 Median $5,011.87 Typical High $16,595.87 | Facility | None | $257.04 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $457.09 | Professional | None | $257.04 | $275.42 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $446.68 | Professional | None | $223.87 | $263.03 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $398.11 Typical High $676.08 | Professional | 50 · Both sides | $338.84 | $398.11 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $346.74 | Facility | None | $269.15 | $269.15 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $380.19 Typical High $1,148.15 | Facility | None | $218.78 | $380.19 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $758.58 | Professional | None | $288.40 | $512.86 | $758.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $275.42 Median $676.08 Typical High $1,778.28 | Facility | None | $275.42 | $676.08 | $1,778.28 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $549.54 | Professional | None | $316.23 | $426.58 | $549.54 |
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 $263.03 Median $426.58 Typical High $758.58 | Professional | None | $263.03 | $426.58 | $758.58 |
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 $128.82 Median $138.04 Typical High $162.18 | Professional | 52 · Reduced service | $128.82 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $66.07 | Professional | 53 · Discontinued | $51.29 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $245.47 | Professional | 54 · Surgery only | $190.55 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $48.98 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.70 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $177.83 | $194.98 | $229.09 |
Where Indiana sits
The same service costs 5.0 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
$389
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.