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 $91.20 Median $131.83 Typical High $3,467.37 | Facility | None | $91.20 | $131.83 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $173.78 | Professional | None | $87.10 | $104.71 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $165.96 | Professional | None | $93.33 | $120.23 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,090.30 Typical High $6,165.95 | Facility | None | $616.60 | $3,090.30 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $147.91 | Professional | None | $93.33 | $120.23 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $165.96 | Facility | None | $107.15 | $107.15 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $158.49 | Professional | None | $114.82 | $128.82 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $128.82 Typical High $223.87 | Facility | None | $66.07 | $128.82 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $177.83 | Professional | None | $97.72 | $128.82 | $177.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $151.36 Median $288.40 Typical High $954.99 | Facility | None | $151.36 | $288.40 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $72.44 Median $144.54 Typical High $218.78 | Professional | None | $72.44 | $144.54 | $218.78 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $181.97 | Professional | None | $81.28 | $112.20 | $181.97 |
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 $43.65 Median $52.48 Typical High $58.88 | Professional | 52 · Reduced service | $43.65 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.89 Typical High $23.99 | Professional | 53 · Discontinued | $17.78 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $79.43 Typical High $89.13 | Professional | 54 · Surgery only | $66.07 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.85 Typical High $17.78 | Professional | 55 · Aftercare only | $13.18 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.47 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.71 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $74.13 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $61.66 | $74.13 | $83.18 |
Where Indiana sits
The same service costs 4.4 times more in Alaska 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· 36th of 51
$123
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.