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 $91.20 Median $3,801.89 Typical High $5,623.41 | Facility | None | $91.20 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $169.82 | Professional | None | $89.13 | $144.54 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $151.36 | Professional | None | $125.89 | $138.04 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $3,090.30 Typical High $6,165.95 | Facility | None | $537.03 | $3,090.30 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $83.18 Typical High $151.36 | Professional | None | $48.98 | $83.18 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $616.60 Typical High $912.01 | Facility | None | $93.33 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $208.93 | Professional | None | $70.79 | $123.03 | $208.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $257.04 Median $575.44 Typical High $2,089.30 | Facility | None | $257.04 | $575.44 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $229.09 | Professional | None | $91.20 | $162.18 | $229.09 |
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 $67.61 Median $123.03 Typical High $239.88 | Professional | None | $67.61 | $123.03 | $239.88 |
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 $44.67 Median $51.29 Typical High $81.28 | Professional | 52 · Reduced service | $44.67 | $51.29 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.42 Typical High $32.36 | Professional | 53 · Discontinued | $17.78 | $20.42 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $75.86 Typical High $123.03 | Professional | 54 · Surgery only | $67.61 | $75.86 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $24.55 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.23 Typical High $16.22 | Professional | 56 · Pre-op care only | $8.91 | $10.23 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $70.79 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $63.10 | $70.79 | $114.82 |
Where Indiana sits
The same service costs 4.5 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· 50th of 51
$105
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.