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 $245.47 Median $407.38 Typical High $5,248.07 | Facility | None | $245.47 | $407.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $436.52 | Professional | None | $234.42 | $323.59 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $549.54 | Professional | None | $169.82 | $169.82 | $549.54 |
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 $245.47 Median $346.74 Typical High $489.78 | Professional | None | $245.47 | $346.74 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $1,479.11 | Facility | None | $288.40 | $288.40 | $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 $275.42 Median $380.19 Typical High $537.03 | Professional | None | $275.42 | $380.19 | $537.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $758.58 Median $1,548.82 Typical High $2,344.23 | Facility | None | $758.58 | $1,548.82 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $602.56 | Professional | None | $281.84 | $426.58 | $602.56 |
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 $251.19 Median $363.08 Typical High $575.44 | Professional | None | $251.19 | $363.08 | $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 $117.49 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $117.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $63.10 Typical High $72.44 | Professional | 53 · Discontinued | $46.77 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $239.88 Typical High $269.15 | Professional | 54 · Surgery only | $173.78 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $47.86 Typical High $53.70 | Professional | 55 · Aftercare only | $34.67 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $31.62 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.44 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $223.87 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $162.18 | $223.87 | $251.19 |
Where Indiana sits
The same service costs 3.9 times more in Alaska than in Utah. 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
$389
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.