How much rates vary
Facilitymedian $1,122 · 10th to 90th $135 to $5,129Professionalmedian $132 · 10th to 90th $85 to $209
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 $97.72 Median $158.49 Typical High $5,011.87 | Facility | None | $97.72 | $158.49 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $199.53 | Professional | None | $89.13 | $128.82 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $173.78 Typical High $218.78 | Professional | None | $66.07 | $173.78 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $6,165.95 | Facility | None | $616.60 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $204.17 | Professional | None | $85.11 | $134.90 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $218.78 | Facility | None | $107.15 | $107.15 | $218.78 |
CareSource Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $194.98 | Professional | None | $141.25 | $154.88 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $213.80 Typical High $794.33 | Facility | None | $128.82 | $213.80 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $229.09 | Professional | None | $97.72 | $131.83 | $229.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $204.17 Median $288.40 Typical High $1,288.25 | Facility | None | $204.17 | $288.40 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $234.42 | Professional | None | $102.33 | $173.78 | $234.42 |
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 $89.13 Median $134.90 Typical High $229.09 | Professional | None | $89.13 | $134.90 | $229.09 |
7 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 $63.10 Typical High $72.44 | Professional | 52 · Reduced service | $43.65 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $25.12 Typical High $28.84 | Professional | 53 · Discontinued | $17.78 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $93.33 Typical High $107.15 | Professional | 54 · Surgery only | $66.07 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $18.62 Typical High $21.38 | Professional | 55 · Aftercare only | $13.18 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.59 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.91 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $87.10 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $61.66 | $87.10 | $100.00 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $81.28 Median $131.83 Typical High $186.21 | Professional | 59 · Distinct service | $81.28 | $131.83 | $186.21 |
Where Indiana sits
The same service costs 3.7 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· 34th of 51
$145
AK $427KY $115
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.