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 $181.97 Median $295.12 Typical High $5,623.41 | Facility | None | $181.97 | $295.12 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $295.12 | Professional | None | $147.91 | $190.55 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $213.80 | Professional | None | $162.18 | $213.80 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $295.12 | Professional | None | $144.54 | $199.53 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $281.84 | Facility | None | $181.97 | $181.97 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $288.40 Typical High $794.33 | Facility | None | $173.78 | $288.40 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $363.08 | Professional | None | $169.82 | $229.09 | $363.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $263.03 Median $489.78 Typical High $2,344.23 | Facility | None | $263.03 | $489.78 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $389.05 | Professional | None | $173.78 | $257.04 | $389.05 |
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 $151.36 Median $208.93 Typical High $338.84 | Professional | None | $151.36 | $208.93 | $338.84 |
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 $93.33 Typical High $104.71 | Professional | 52 · Reduced service | $74.13 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $37.15 Typical High $41.69 | Professional | 53 · Discontinued | $29.51 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $141.25 Typical High $158.49 | Professional | 54 · Surgery only | $112.20 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $22.39 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.79 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $131.83 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $104.71 | $131.83 | $147.91 |
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
$224
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.