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 $151.36 Median $489.78 Typical High $7,244.36 | Facility | None | $151.36 | $489.78 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $309.03 | Professional | None | $151.36 | $218.78 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $380.19 | Professional | None | $158.49 | $251.19 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $1,479.11 | Facility | None | $186.21 | $186.21 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,148.15 Typical High $2,089.30 | Facility | None | $562.34 | $1,148.15 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $398.11 | Professional | None | $190.55 | $263.03 | $398.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $512.86 Median $1,548.82 Typical High $3,019.95 | Facility | None | $512.86 | $1,548.82 | $3,019.95 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $398.11 | Professional | None | $177.83 | $302.00 | $398.11 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $398.11 | Professional | None | $165.96 | $239.88 | $398.11 |
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 $75.86 Median $107.15 Typical High $123.03 | Professional | 52 · Reduced service | $75.86 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $42.66 Typical High $48.98 | Professional | 53 · Discontinued | $30.20 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $162.18 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.14 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $151.36 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $107.15 | $151.36 | $169.82 |
Where Indiana sits
The same service costs 4.2 times more in Alaska than in Utah. 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
$263
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.