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 $74.13 Median $162.18 Typical High $5,011.87 | Facility | None | $74.13 | $162.18 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $120.23 | Professional | None | $74.13 | $91.20 | $120.23 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 50 · Both sides | $131.83 | $131.83 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $109.65 | Professional | None | $67.61 | $81.28 | $109.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $123.03 Typical High $165.96 | Professional | 50 · Both sides | $102.33 | $123.03 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $616.60 Typical High $912.01 | Facility | None | $77.62 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $165.96 | Professional | None | $74.13 | $93.33 | $165.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $204.17 Median $281.84 Typical High $2,089.30 | Facility | None | $204.17 | $281.84 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $173.78 | Professional | None | $95.50 | $128.82 | $173.78 |
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 $74.13 Median $104.71 Typical High $177.83 | Professional | None | $74.13 | $104.71 | $177.83 |
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 $37.15 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $37.15 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.20 Typical High $21.38 | Professional | 53 · Discontinued | $14.79 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $67.61 Typical High $79.43 | Professional | 54 · Surgery only | $54.95 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.49 Typical High $15.85 | Professional | 55 · Aftercare only | $10.96 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.41 | $9.12 | $10.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $63.10 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $51.29 | $63.10 | $74.13 |
Where Indiana sits
The same service costs 4.2 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· 48th of 51
$93.33
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.