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 $134.90 Median $199.53 Typical High $5,011.87 | Facility | None | $134.90 | $199.53 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $251.19 | Professional | None | $123.03 | $162.18 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $181.97 | Professional | None | $109.65 | $109.65 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $245.47 | Professional | None | $117.49 | $158.49 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $257.04 | Facility | None | $147.91 | $147.91 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $239.88 | Professional | None | $173.78 | $194.98 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $257.04 Typical High $794.33 | Facility | None | $154.88 | $257.04 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $295.12 | Professional | None | $138.04 | $186.21 | $295.12 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $239.88 Median $467.74 Typical High $2,089.30 | Facility | None | $239.88 | $467.74 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $323.59 | Professional | None | $144.54 | $218.78 | $323.59 |
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 $123.03 Median $177.83 Typical High $288.40 | Professional | None | $123.03 | $177.83 | $288.40 |
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 $61.66 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $61.66 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $31.62 Typical High $35.48 | Professional | 53 · Discontinued | $24.55 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $117.49 Typical High $131.83 | Professional | 54 · Surgery only | $91.20 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $18.20 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.30 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $109.65 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $85.11 | $109.65 | $123.03 |
Where Indiana sits
The same service costs 3.9 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· 37th of 51
$186
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.