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 $1,096.48 Median $5,011.87 Typical High $17,782.79 | Facility | None | $1,096.48 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,096.48 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $23,442.29 Typical High $46,773.51 | Facility | None | $1,513.56 | $23,442.29 | $46,773.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,737.80 | Professional | None | $870.96 | $1,288.25 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,698.24 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,318.26 | $1,995.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,630.27 Typical High $16,595.87 | Facility | None | $912.01 | $2,630.27 | $16,595.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,412.54 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,348.96 | $2,137.96 |
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 $537.03 Median $549.54 Typical High $676.08 | Professional | 52 · Reduced service | $537.03 | $549.54 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $269.15 | Professional | 53 · Discontinued | $213.80 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $1,023.29 | Professional | 54 · Surgery only | $794.33 | $831.76 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $204.17 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $134.90 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $954.99 |
Where Indiana sits
The same service costs 8.9 times more in Oklahoma 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· 41st of 51
$1,349
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.