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 $190.55 Median $354.81 Typical High $5,495.41 | Facility | None | $190.55 | $354.81 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $354.81 | Professional | None | $162.18 | $234.42 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $194.98 | Professional | None | $117.49 | $128.82 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $6,165.95 | Facility | None | $616.60 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $309.03 | Professional | None | $154.88 | $223.87 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $346.74 | Facility | None | $194.98 | $194.98 | $346.74 |
CareSource Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $346.74 | Professional | None | $251.19 | $281.84 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $794.33 | Facility | None | $208.93 | $346.74 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $363.08 | Professional | None | $158.49 | $229.09 | $363.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,089.30 | Facility | None | $323.59 | $524.81 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $416.87 | Professional | None | $190.55 | $309.03 | $416.87 |
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 $162.18 Median $251.19 Typical High $407.38 | Professional | None | $162.18 | $251.19 | $407.38 |
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 $79.43 Median $112.20 Typical High $128.82 | Professional | 52 · Reduced service | $79.43 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $45.71 Typical High $51.29 | Professional | 53 · Discontinued | $32.36 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $190.55 | Professional | 54 · Surgery only | $120.23 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.88 Typical High $38.02 | Professional | 55 · Aftercare only | $23.99 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.91 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.22 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $158.49 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $112.20 | $158.49 | $177.83 |
Where Indiana sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$257
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.