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 $234.42 Median $3,801.89 Typical High $5,623.41 | Facility | None | $234.42 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $478.63 | Professional | None | $234.42 | $407.38 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $6,165.95 | Facility | None | $616.60 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $407.38 | Professional | None | $204.17 | $338.84 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $512.86 Typical High $616.60 | Professional | 50 · Both sides | $302.00 | $512.86 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $331.13 | Facility | None | $251.19 | $251.19 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $524.81 | Facility | None | $66.07 | $275.42 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $870.96 | Professional | None | $199.53 | $346.74 | $870.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $263.03 Median $446.68 Typical High $1,230.27 | Facility | None | $263.03 | $446.68 | $1,230.27 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $776.25 | Professional | None | $281.84 | $512.86 | $776.25 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $245.47 Median $407.38 Typical High $691.83 | Professional | None | $245.47 | $407.38 | $691.83 |
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 $117.49 Median $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $117.49 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $81.28 Typical High $95.50 | Professional | 53 · Discontinued | $47.86 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $177.83 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $60.26 Typical High $72.44 | Professional | 55 · Aftercare only | $35.48 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $23.44 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $281.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $165.96 | $281.84 | $338.84 |
Where Indiana sits
The same service costs 3.4 times more in Alaska than in Maryland. 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
$380
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.