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 $1,122.02 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,122.02 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,122.02 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $38,904.51 Typical High $77,624.71 | Facility | None | $2,570.40 | $38,904.51 | $77,624.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,348.96 | Professional | None | $977.24 | $1,148.15 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $2,691.53 | Facility | None | $524.81 | $1,096.48 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $5,623.41 | Professional | None | $1,071.52 | $1,071.52 | $5,623.41 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,584.89 Typical High $3,162.28 | Facility | None | $912.01 | $1,584.89 | $3,162.28 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,698.24 | Professional | None | $812.83 | $1,122.02 | $1,698.24 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,862.09 | Professional | None | $977.24 | $1,202.26 | $1,862.09 |
4 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 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $204.17 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $954.99 |
Where Indiana sits
The same service costs 16.2 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· 33rd of 51
$1,148
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.