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 $218.78 Median $398.11 Typical High $5,011.87 | Facility | None | $218.78 | $398.11 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $501.19 | Professional | None | $204.17 | $323.59 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $363.08 | Professional | None | $281.84 | $331.13 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $3,235.94 Typical High $6,309.57 | Facility | None | $891.25 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $457.09 | Professional | None | $204.17 | $363.08 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $676.08 | Facility | None | $245.47 | $245.47 | $676.08 |
CareSource Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $489.78 | Professional | None | $354.81 | $398.11 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $691.83 Typical High $1,479.11 | Facility | None | $467.74 | $691.83 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $562.34 | Professional | None | $257.04 | $371.54 | $562.34 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $588.84 Median $891.25 Typical High $1,995.26 | Facility | None | $588.84 | $891.25 | $1,995.26 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $245.47 Median $426.58 Typical High $549.54 | Professional | None | $245.47 | $426.58 | $549.54 |
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 $229.09 Median $346.74 Typical High $575.44 | Professional | None | $229.09 | $346.74 | $575.44 |
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 $102.33 Median $154.88 Typical High $181.97 | Professional | 52 · Reduced service | $102.33 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $61.66 Typical High $72.44 | Professional | 53 · Discontinued | $40.74 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $229.09 Typical High $275.42 | Professional | 54 · Surgery only | $154.88 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $45.71 Typical High $54.95 | Professional | 55 · Aftercare only | $30.90 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $20.42 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $213.80 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $144.54 | $213.80 | $257.04 |
Where Indiana sits
The same service costs 3.3 times more in Alaska than in Utah. 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
$380
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.