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 $467.74 Median $5,011.87 Typical High $16,595.87 | Facility | None | $467.74 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $645.65 | Professional | None | $467.74 | $489.78 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $6,165.95 | Facility | None | $616.60 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $724.44 | Professional | None | $407.38 | $478.63 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $724.44 Typical High $1,096.48 | Professional | 50 · Both sides | $602.56 | $724.44 | $1,096.48 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $562.34 | Facility | None | $489.78 | $489.78 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $562.34 Typical High $1,047.13 | Facility | None | $338.84 | $562.34 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $851.14 | Professional | None | $398.11 | $602.56 | $851.14 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $389.05 Median $794.33 Typical High $1,548.82 | Facility | None | $389.05 | $794.33 | $1,548.82 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $933.25 | Professional | None | $562.34 | $758.58 | $933.25 |
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 $478.63 Median $616.60 Typical High $1,071.52 | Professional | None | $478.63 | $616.60 | $1,071.52 |
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 $234.42 Median $239.88 Typical High $281.84 | Professional | 52 · Reduced service | $234.42 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $114.82 | Professional | 53 · Discontinued | $93.33 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $363.08 Typical High $426.58 | Professional | 54 · Surgery only | $346.74 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $72.44 Typical High $85.11 | Professional | 55 · Aftercare only | $69.18 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $57.54 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $338.84 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $323.59 | $338.84 | $398.11 |
Where Indiana sits
The same service costs 6.2 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· 40th of 51
$562
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.