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 $186.21 Median $5,011.87 Typical High $11,220.18 | Facility | None | $186.21 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $354.81 | Professional | None | $186.21 | $295.12 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $309.03 Typical High $371.54 | Professional | None | $169.82 | $309.03 | $371.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $457.09 Typical High $562.34 | Professional | 50 · Both sides | $251.19 | $457.09 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $467.74 | Facility | None | $194.98 | $194.98 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $457.09 Typical High $812.83 | Facility | None | $295.12 | $457.09 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $691.83 | Professional | None | $177.83 | $263.03 | $691.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $3,388.44 | Facility | None | $371.54 | $602.56 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $562.34 | Professional | None | $239.88 | $389.05 | $562.34 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $501.19 | Professional | None | $194.98 | $302.00 | $501.19 |
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 $93.33 Median $147.91 Typical High $177.83 | Professional | 52 · Reduced service | $93.33 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $58.88 Typical High $70.79 | Professional | 53 · Discontinued | $37.15 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $138.04 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $27.54 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $29.51 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.62 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $128.82 | $208.93 | $245.47 |
Where Indiana sits
The same service costs 4.3 times more in Wyoming 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· 38th of 51
$309
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.