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 $1,174.90 Median $5,011.87 Typical High $17,782.79 | Facility | None | $1,174.90 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,174.90 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,737.80 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,348.96 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,041.74 Typical High $2,884.03 | Professional | 50 · Both sides | $1,621.81 | $2,041.74 | $2,884.03 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $6,025.60 | Facility | None | $1,288.25 | $1,288.25 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $4,466.84 Typical High $6,606.93 | Facility | None | $1,230.27 | $4,466.84 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,548.82 | $2,511.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $6,165.95 Typical High $8,511.38 | Facility | None | $2,089.30 | $6,165.95 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,584.89 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,412.54 | $2,398.83 |
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 $549.54 Median $588.84 Typical High $630.96 | Professional | 52 · Reduced service | $549.54 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $251.19 | Professional | 53 · Discontinued | $218.78 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $954.99 | Professional | 54 · Surgery only | $812.83 | $891.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $125.89 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $891.25 |
Where Indiana sits
The same service costs 6.2 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· 43rd of 51
$1,413
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.