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 $120.23 Median $213.80 Typical High $5,011.87 | Facility | None | $120.23 | $213.80 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $190.55 | Professional | None | $104.71 | $162.18 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $95.50 Typical High $123.03 | Professional | None | $44.67 | $95.50 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $3,235.94 Typical High $6,309.57 | Facility | None | $724.44 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $263.03 | Professional | None | $107.15 | $173.78 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $251.19 | Facility | None | $109.65 | $109.65 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $194.98 Typical High $331.13 | Facility | None | $66.07 | $194.98 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $288.40 | Professional | None | $117.49 | $190.55 | $288.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $223.87 Median $323.59 Typical High $1,995.26 | Facility | None | $223.87 | $323.59 | $1,995.26 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $257.04 | Professional | None | $107.15 | $190.55 | $257.04 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $281.84 | Professional | None | $107.15 | $165.96 | $281.84 |
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 $52.48 Median $74.13 Typical High $91.20 | Professional | 52 · Reduced service | $52.48 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $29.51 Typical High $37.15 | Professional | 53 · Discontinued | $20.89 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $109.65 Typical High $138.04 | Professional | 54 · Surgery only | $79.43 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $15.85 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.79 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.47 | $14.79 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $102.33 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $74.13 | $102.33 | $128.82 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 33rd of 51
$182
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.