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 $676.08 Median $1,148.15 Typical High $11,220.18 | Facility | None | $676.08 | $1,148.15 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,122.02 | Professional | None | $676.08 | $831.76 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $891.25 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,288.25 | Professional | None | $676.08 | $954.99 | $1,288.25 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $2,041.74 | Facility | None | $831.76 | $831.76 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,737.80 Typical High $2,691.53 | Facility | None | $630.96 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,584.89 | Professional | None | $724.44 | $1,000.00 | $1,584.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,023.29 Median $2,290.87 Typical High $3,090.30 | Facility | None | $1,023.29 | $2,290.87 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,737.80 | Professional | None | $794.33 | $1,096.48 | $1,737.80 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,513.56 | Professional | None | $691.83 | $954.99 | $1,513.56 |
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 $338.84 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $338.84 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $134.90 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $512.86 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $102.33 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $67.61 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $478.63 | $575.44 | $645.65 |
Where Indiana sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 35th of 51
$1,000
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.