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 $851.14 Median $5,011.87 Typical High $17,782.79 | Facility | None | $851.14 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,023.29 | Professional | None | $794.33 | $851.14 | $1,023.29 |
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 $758.58 Median $1,071.52 Typical High $1,445.44 | Professional | None | $758.58 | $1,071.52 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,621.81 Typical High $2,187.76 | Professional | 50 · Both sides | $1,148.15 | $1,621.81 | $2,187.76 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $6,025.60 | Facility | None | $912.01 | $912.01 | $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 $912.01 Median $1,122.02 Typical High $1,737.80 | Professional | None | $912.01 | $1,122.02 | $1,737.80 |
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 $912.01 Median $1,122.02 Typical High $1,698.24 | Professional | None | $912.01 | $1,122.02 | $1,698.24 |
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 $831.76 Median $1,023.29 Typical High $1,737.80 | Professional | None | $831.76 | $1,023.29 | $1,737.80 |
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 $389.05 Median $416.87 Typical High $446.68 | Professional | 52 · Reduced service | $389.05 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $177.83 | Professional | 53 · Discontinued | $158.49 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $676.08 | Professional | 54 · Surgery only | $588.84 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $125.89 Typical High $134.90 | Professional | 55 · Aftercare only | $117.49 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $89.13 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $588.84 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $549.54 | $588.84 | $630.96 |
Where Indiana sits
The same service costs 7.2 times more in Alaska than in Texas. 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· 42nd of 51
$1,096
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.