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 $147.91 Median $213.80 Typical High $5,011.87 | Facility | None | $147.91 | $213.80 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $269.15 | Professional | None | $128.82 | $169.82 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $147.91 | Professional | None | $100.00 | $147.91 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $269.15 | Professional | None | $125.89 | $177.83 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $257.04 | Facility | None | $158.49 | $158.49 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $263.03 Typical High $794.33 | Facility | None | $158.49 | $263.03 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $323.59 | Professional | None | $147.91 | $204.17 | $323.59 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $239.88 Median $467.74 Typical High $2,344.23 | Facility | None | $239.88 | $467.74 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $346.74 | Professional | None | $154.88 | $234.42 | $346.74 |
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 $131.83 Median $190.55 Typical High $309.03 | Professional | None | $131.83 | $190.55 | $309.03 |
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 $64.57 Median $85.11 Typical High $93.33 | Professional | 52 · Reduced service | $64.57 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.88 Typical High $38.02 | Professional | 53 · Discontinued | $25.70 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $125.89 Typical High $141.25 | Professional | 54 · Surgery only | $97.72 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $25.12 Typical High $28.18 | Professional | 55 · Aftercare only | $19.50 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.98 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.88 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $117.49 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $91.20 | $117.49 | $131.83 |
Where Indiana sits
The same service costs 4.0 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· 41st of 51
$195
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.