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 $302.00 Typical High $5,623.41 | Facility | None | $120.23 | $302.00 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $338.84 | Professional | None | $120.23 | $213.80 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | None | $208.93 | $223.87 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $1,621.81 Typical High $5,370.32 | Facility | None | $194.98 | $1,621.81 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $302.00 | Professional | None | $120.23 | $204.17 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $371.54 | Facility | None | $147.91 | $147.91 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $288.40 Typical High $489.78 | Facility | None | $66.07 | $288.40 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $363.08 | Professional | None | $147.91 | $218.78 | $363.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,288.25 | Facility | None | $281.84 | $457.09 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $363.08 | Professional | None | $147.91 | $257.04 | $363.08 |
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 $134.90 Median $213.80 Typical High $363.08 | Professional | None | $134.90 | $213.80 | $363.08 |
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 $60.26 Median $95.50 Typical High $120.23 | Professional | 52 · Reduced service | $60.26 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $38.02 Typical High $47.86 | Professional | 53 · Discontinued | $23.99 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $144.54 Typical High $181.97 | Professional | 54 · Surgery only | $91.20 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $28.84 Typical High $36.31 | Professional | 55 · Aftercare only | $18.20 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $19.05 Typical High $23.99 | Professional | 56 · Pre-op care only | $12.02 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $134.90 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $85.11 | $134.90 | $169.82 |
Where Indiana sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 41st of 51
$224
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.