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 $181.97 Median $691.83 Typical High $7,244.36 | Facility | None | $181.97 | $691.83 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $398.11 | Professional | None | $181.97 | $309.03 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $1,778.28 Typical High $5,370.32 | Facility | None | $245.47 | $1,778.28 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $426.58 | Professional | None | $190.55 | $302.00 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $446.68 | Facility | None | $223.87 | $223.87 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $446.68 Typical High $977.24 | Facility | None | $269.15 | $446.68 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $489.78 | Professional | None | $223.87 | $346.74 | $489.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $323.59 Median $562.34 Typical High $1,288.25 | Facility | None | $323.59 | $562.34 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $537.03 | Professional | None | $218.78 | $380.19 | $537.03 |
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 $199.53 Median $309.03 Typical High $537.03 | Professional | None | $199.53 | $309.03 | $537.03 |
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 $91.20 Median $134.90 Typical High $177.83 | Professional | 52 · Reduced service | $91.20 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $53.70 Typical High $70.79 | Professional | 53 · Discontinued | $36.31 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $204.17 Typical High $269.15 | Professional | 54 · Surgery only | $138.04 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $40.74 Typical High $53.70 | Professional | 55 · Aftercare only | $27.54 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.92 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.20 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $190.55 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $128.82 | $190.55 | $251.19 |
Where Indiana sits
The same service costs 3.5 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· 36th of 51
$339
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.