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 $154.88 Median $288.40 Typical High $5,011.87 | Facility | None | $154.88 | $288.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $363.08 | Professional | None | $141.25 | $229.09 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $239.88 | Professional | None | $194.98 | $208.93 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $338.84 | Professional | None | $141.25 | $223.87 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $389.05 | Facility | None | $169.82 | $169.82 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $346.74 | Professional | None | $251.19 | $281.84 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $302.00 Typical High $512.86 | Facility | None | $66.07 | $302.00 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $416.87 | Professional | None | $173.78 | $263.03 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $354.81 Median $501.19 Typical High $954.99 | Facility | None | $354.81 | $501.19 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $165.96 Median $295.12 Typical High $398.11 | Professional | None | $165.96 | $295.12 | $398.11 |
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 $151.36 Median $234.42 Typical High $389.05 | Professional | None | $151.36 | $234.42 | $389.05 |
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 $70.79 Median $102.33 Typical High $128.82 | Professional | 52 · Reduced service | $70.79 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $52.48 | Professional | 53 · Discontinued | $28.18 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $154.88 Typical High $194.98 | Professional | 54 · Surgery only | $104.71 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $30.90 Typical High $38.90 | Professional | 55 · Aftercare only | $20.89 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.42 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.13 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $144.54 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $97.72 | $144.54 | $181.97 |
Where Indiana sits
The same service costs 3.4 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· 38th of 51
$251
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.