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 $588.84 Median $5,011.87 Typical High $14,125.38 | Facility | None | $588.84 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $794.33 | Professional | None | $588.84 | $588.84 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $9,549.93 | Facility | None | $1,174.90 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $954.99 | Professional | None | $501.19 | $758.58 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,148.15 Typical High $1,513.56 | Professional | 50 · Both sides | $758.58 | $1,148.15 | $1,513.56 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $2,137.96 | Facility | None | $616.60 | $616.60 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,659.59 Typical High $3,090.30 | Facility | None | $724.44 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,174.90 | Professional | None | $426.58 | $645.65 | $1,174.90 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,096.48 Median $2,187.76 Typical High $3,388.44 | Facility | None | $1,096.48 | $2,187.76 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,258.93 | Professional | None | $691.83 | $954.99 | $1,258.93 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,148.15 | Professional | None | $512.86 | $676.08 | $1,148.15 |
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 $295.12 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $295.12 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $524.81 | Professional | 54 · Surgery only | $436.52 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $489.78 |
Where Indiana sits
The same service costs 7.6 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· 30th of 51
$759
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.