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 $186.21 Median $323.59 Typical High $5,011.87 | Facility | None | $186.21 | $323.59 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $354.81 | Professional | None | $177.83 | $257.04 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $363.08 | Professional | None | $144.54 | $257.04 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $3,235.94 Typical High $6,165.95 | Facility | None | $630.96 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $346.74 | Professional | None | $173.78 | $245.47 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $776.25 | Facility | None | $213.80 | $213.80 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $660.69 Typical High $1,174.90 | Facility | None | $446.68 | $660.69 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $416.87 | Professional | None | $173.78 | $263.03 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $537.03 Median $912.01 Typical High $2,187.76 | Facility | None | $537.03 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $457.09 | Professional | None | $208.93 | $338.84 | $457.09 |
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 $181.97 Median $275.42 Typical High $457.09 | Professional | None | $181.97 | $275.42 | $457.09 |
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 $89.13 Median $125.89 Typical High $144.54 | Professional | 52 · Reduced service | $89.13 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $35.48 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $190.55 Typical High $213.80 | Professional | 54 · Surgery only | $131.83 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.02 Typical High $42.66 | Professional | 55 · Aftercare only | $26.30 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.12 Typical High $28.84 | Professional | 56 · Pre-op care only | $17.78 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $177.83 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $123.03 | $177.83 | $199.53 |
Where Indiana sits
The same service costs 3.6 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· 42nd of 51
$288
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.