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 $128.82 Median $3,467.37 Typical High $7,244.36 | Facility | None | $128.82 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $251.19 Typical High $302.00 | Professional | None | $128.82 | $251.19 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $223.87 | Professional | None | $112.20 | $165.96 | $223.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $245.47 Typical High $338.84 | Professional | 50 · Both sides | $169.82 | $245.47 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $1,023.29 | Facility | None | $138.04 | $138.04 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $831.76 Typical High $1,621.81 | Facility | None | $549.54 | $831.76 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $537.03 | Professional | None | $107.15 | $199.53 | $537.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $371.54 Median $1,071.52 Typical High $2,089.30 | Facility | None | $371.54 | $1,071.52 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $478.63 | Professional | None | $158.49 | $288.40 | $478.63 |
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 $131.83 Median $239.88 Typical High $426.58 | Professional | None | $131.83 | $239.88 | $426.58 |
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 $64.57 Median $125.89 Typical High $151.36 | Professional | 52 · Reduced service | $64.57 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $50.12 Typical High $60.26 | Professional | 53 · Discontinued | $25.70 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $190.55 Typical High $223.87 | Professional | 54 · Surgery only | $95.50 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $38.02 Typical High $44.67 | Professional | 55 · Aftercare only | $19.05 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $25.12 Typical High $30.20 | Professional | 56 · Pre-op care only | $12.88 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $177.83 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $89.13 | $177.83 | $208.93 |
Where Indiana sits
The same service costs 4.7 times more in Alaska than in Virginia. 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
$240
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.