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 $288.40 Median $407.38 Typical High $5,248.07 | Facility | None | $288.40 | $407.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $457.09 | Professional | None | $263.03 | $316.23 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,413.10 Typical High $17,378.01 | Facility | None | $758.58 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $478.63 | Professional | None | $263.03 | $309.03 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $2,511.89 | Facility | None | $323.59 | $323.59 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $2,691.53 | Facility | None | $549.54 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $562.34 | Professional | None | $281.84 | $389.05 | $562.34 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $870.96 Median $2,238.72 Typical High $4,168.69 | Facility | None | $870.96 | $2,238.72 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $660.69 | Professional | None | $275.42 | $426.58 | $660.69 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $575.44 | Professional | None | $269.15 | $371.54 | $575.44 |
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 $131.83 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $131.83 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $64.57 Typical High $70.79 | Professional | 53 · Discontinued | $52.48 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $239.88 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $47.86 Typical High $53.70 | Professional | 55 · Aftercare only | $39.81 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $31.62 Typical High $35.48 | Professional | 56 · Pre-op care only | $26.30 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $223.87 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $181.97 | $223.87 | $251.19 |
Where Indiana sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 44th of 51
$363
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.