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 $138.04 Median $3,801.89 Typical High $5,623.41 | Facility | None | $138.04 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $190.55 | Professional | None | $138.04 | $147.91 | $190.55 |
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 $123.03 Median $181.97 Typical High $239.88 | Professional | None | $123.03 | $181.97 | $239.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $269.15 Typical High $354.81 | Professional | 50 · Both sides | $186.21 | $269.15 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $177.83 | Facility | None | $147.91 | $147.91 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $186.21 Typical High $724.44 | Facility | None | $112.20 | $186.21 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $407.38 | Professional | None | $109.65 | $162.18 | $407.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $141.25 Median $380.19 Typical High $3,388.44 | Facility | None | $141.25 | $380.19 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $288.40 | Professional | None | $173.78 | $234.42 | $288.40 |
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 $131.83 Median $165.96 Typical High $281.84 | Professional | None | $131.83 | $165.96 | $281.84 |
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 $69.18 Median $74.13 Typical High $89.13 | Professional | 52 · Reduced service | $69.18 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $29.51 Typical High $35.48 | Professional | 53 · Discontinued | $28.18 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $112.20 Typical High $131.83 | Professional | 54 · Surgery only | $104.71 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $22.39 Typical High $26.30 | Professional | 55 · Aftercare only | $20.89 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.79 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.80 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $104.71 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $97.72 | $104.71 | $123.03 |
Where Indiana sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 32nd of 51
$182
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.