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 $107.15 Median $275.42 Typical High $5,011.87 | Facility | None | $107.15 | $275.42 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $338.84 | Professional | None | $87.10 | $169.82 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $239.88 | Professional | None | $89.13 | $158.49 | $239.88 |
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 $83.18 Median $138.04 Typical High $251.19 | Professional | None | $83.18 | $138.04 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $398.11 | Facility | None | $104.71 | $104.71 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $346.74 Typical High $588.84 | Facility | None | $66.07 | $346.74 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $323.59 | Professional | None | $102.33 | $169.82 | $323.59 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $295.12 Median $562.34 Typical High $2,089.30 | Facility | None | $295.12 | $562.34 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $104.71 Median $223.87 Typical High $346.74 | Professional | None | $104.71 | $223.87 | $346.74 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $89.13 Median $154.88 Typical High $295.12 | Professional | None | $89.13 | $154.88 | $295.12 |
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 $64.57 Typical High $114.82 | Professional | 52 · Reduced service | $43.65 | $64.57 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $25.70 Typical High $45.71 | Professional | 53 · Discontinued | $17.38 | $25.70 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $95.50 Typical High $173.78 | Professional | 54 · Surgery only | $64.57 | $95.50 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $19.05 Typical High $34.67 | Professional | 55 · Aftercare only | $12.88 | $19.05 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.88 Typical High $22.91 | Professional | 56 · Pre-op care only | $8.71 | $12.88 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $89.13 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $60.26 | $89.13 | $162.18 |
Where Indiana sits
The same service costs 4.1 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· 49th of 51
$162
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.