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 $208.93 Median $346.74 Typical High $5,248.07 | Facility | None | $208.93 | $346.74 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $371.54 | Professional | None | $194.98 | $281.84 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $398.11 | Professional | None | $194.98 | $316.23 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $1,479.11 | Facility | None | $239.88 | $239.88 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,096.48 Typical High $2,089.30 | Facility | None | $549.54 | $1,096.48 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $457.09 | Professional | None | $208.93 | $309.03 | $457.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $645.65 Median $1,548.82 Typical High $3,019.95 | Facility | None | $645.65 | $1,548.82 | $3,019.95 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $512.86 | Professional | None | $234.42 | $380.19 | $512.86 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $489.78 | Professional | None | $204.17 | $302.00 | $489.78 |
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 $97.72 Median $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $97.72 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $39.81 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $147.91 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $41.69 Typical High $46.77 | Professional | 55 · Aftercare only | $29.51 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.50 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $190.55 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $138.04 | $190.55 | $218.78 |
Where Indiana sits
The same service costs 4.0 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· 36th of 51
$331
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.