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 $302.00 Typical High $5,011.87 | Facility | None | $181.97 | $302.00 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $346.74 | Professional | None | $173.78 | $245.47 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
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 $165.96 Median $275.42 Typical High $346.74 | Professional | None | $165.96 | $275.42 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $363.08 | Facility | None | $213.80 | $213.80 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $288.40 Typical High $512.86 | Facility | None | $66.07 | $288.40 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $416.87 | Professional | None | $186.21 | $263.03 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $338.84 Median $562.34 Typical High $2,344.23 | Facility | None | $338.84 | $562.34 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $457.09 | Professional | None | $208.93 | $331.13 | $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 $269.15 Typical High $436.52 | Professional | None | $181.97 | $269.15 | $436.52 |
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 $87.10 Median $120.23 Typical High $134.90 | Professional | 52 · Reduced service | $87.10 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $34.67 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $181.97 Typical High $204.17 | Professional | 54 · Surgery only | $131.83 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $36.31 Typical High $40.74 | Professional | 55 · Aftercare only | $26.30 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.38 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $169.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $123.03 | $169.82 | $190.55 |
Where Indiana sits
The same service costs 3.9 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· 42nd of 51
$275
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.