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 $120.23 Median $5,011.87 Typical High $7,244.36 | Facility | None | $120.23 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $194.98 | Professional | None | $114.82 | $169.82 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $213.80 | Professional | None | $95.50 | $147.91 | $213.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $218.78 Typical High $331.13 | Professional | 50 · Both sides | $141.25 | $218.78 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $323.59 | Facility | None | $128.82 | $128.82 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $302.00 Typical High $933.25 | Facility | None | $165.96 | $302.00 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $331.13 | Professional | None | $131.83 | $177.83 | $331.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $309.03 Median $562.34 Typical High $2,187.76 | Facility | None | $309.03 | $562.34 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $354.81 | Professional | None | $134.90 | $223.87 | $354.81 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $338.84 | Professional | None | $120.23 | $194.98 | $338.84 |
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 $57.54 Median $85.11 Typical High $95.50 | Professional | 52 · Reduced service | $57.54 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $33.88 Typical High $38.90 | Professional | 53 · Discontinued | $22.91 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $125.89 Typical High $144.54 | Professional | 54 · Surgery only | $87.10 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.70 Typical High $28.84 | Professional | 55 · Aftercare only | $17.38 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.98 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.48 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $117.49 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $81.28 | $117.49 | $134.90 |
Where Indiana sits
The same service costs 3.9 times more in Oklahoma than in Kentucky. 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· 50th of 51
$174
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.