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 $169.82 Median $251.19 Typical High $5,011.87 | Facility | None | $169.82 | $251.19 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $309.03 | Professional | None | $147.91 | $194.98 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
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 $144.54 Median $199.53 Typical High $309.03 | Professional | None | $144.54 | $199.53 | $309.03 |
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 $549.54 Median $1,096.48 Typical High $2,089.30 | Facility | None | $549.54 | $1,096.48 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $323.59 | Professional | None | $169.82 | $229.09 | $323.59 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $489.78 Median $1,548.82 Typical High $3,019.95 | Facility | None | $489.78 | $1,548.82 | $3,019.95 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $398.11 | Professional | None | $173.78 | $269.15 | $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 $154.88 Median $218.78 Typical High $354.81 | Professional | None | $154.88 | $218.78 | $354.81 |
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 $74.13 Median $97.72 Typical High $109.65 | Professional | 52 · Reduced service | $74.13 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $38.90 Typical High $43.65 | Professional | 53 · Discontinued | $29.51 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $147.91 Typical High $162.18 | Professional | 54 · Surgery only | $112.20 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $29.51 Typical High $32.36 | Professional | 55 · Aftercare only | $22.39 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $19.50 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.79 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $138.04 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $104.71 | $138.04 | $151.36 |
Where Indiana sits
The same service costs 4.7 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· 41st of 51
$229
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.