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 $288.40 Median $3,467.37 Typical High $11,220.18 | Facility | None | $288.40 | $3,467.37 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $524.81 | Professional | None | $288.40 | $446.68 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $891.25 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $436.52 | Professional | None | $263.03 | $323.59 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $489.78 Typical High $676.08 | Professional | 50 · Both sides | $389.05 | $489.78 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $2,137.96 | Facility | None | $309.03 | $309.03 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $2,691.53 | Facility | None | $630.96 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $758.58 | Professional | None | $234.42 | $354.81 | $758.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $851.14 Median $1,905.46 Typical High $3,388.44 | Facility | None | $851.14 | $1,905.46 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $851.14 | Professional | None | $371.54 | $588.84 | $851.14 |
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 $269.15 Median $436.52 Typical High $741.31 | Professional | None | $269.15 | $436.52 | $741.31 |
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 $144.54 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $144.54 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $89.13 Typical High $107.15 | Professional | 53 · Discontinued | $57.54 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $218.78 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $43.65 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $44.67 Typical High $52.48 | Professional | 56 · Pre-op care only | $28.84 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $204.17 | $316.23 | $371.54 |
Where Indiana sits
The same service costs 5.9 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· 38th of 51
$447
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.