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 $91.20 Median $3,801.89 Typical High $5,623.41 | Facility | None | $91.20 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $223.87 Typical High $269.15 | Professional | None | $91.20 | $223.87 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $158.49 | Professional | None | $81.28 | $114.82 | $158.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $169.82 Typical High $239.88 | Professional | 50 · Both sides | $123.03 | $169.82 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $389.05 | Facility | None | $95.50 | $95.50 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $354.81 Typical High $724.44 | Facility | None | $104.71 | $354.81 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $165.96 Typical High $363.08 | Professional | None | $72.44 | $165.96 | $363.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $263.03 Median $512.86 Typical High $2,089.30 | Facility | None | $263.03 | $512.86 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $114.82 Median $245.47 Typical High $426.58 | Professional | None | $114.82 | $245.47 | $426.58 |
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 $91.20 Median $190.55 Typical High $371.54 | Professional | None | $91.20 | $190.55 | $371.54 |
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 $45.71 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $45.71 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $44.67 Typical High $53.70 | Professional | 53 · Discontinued | $18.20 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $165.96 Typical High $204.17 | Professional | 54 · Surgery only | $69.18 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $13.80 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $22.39 Typical High $26.92 | Professional | 56 · Pre-op care only | $9.12 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $64.57 | $158.49 | $190.55 |
Where Indiana sits
The same service costs 5.6 times more in Alaska than in Kentucky. 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· 47th of 51
$174
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.