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 $295.12 Median $1,380.38 Typical High $5,011.87 | Facility | None | $295.12 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $407.38 | Professional | None | $295.12 | $371.54 | $407.38 |
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 $302.00 Median $416.87 Typical High $588.84 | Professional | None | $302.00 | $416.87 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $446.68 | Facility | None | $363.08 | $363.08 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $912.01 | Facility | None | $269.15 | $426.58 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $691.83 | Professional | None | $295.12 | $446.68 | $691.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $338.84 Median $575.44 Typical High $1,318.26 | Facility | None | $338.84 | $575.44 | $1,318.26 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $776.25 | Professional | None | $346.74 | $512.86 | $776.25 |
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 $309.03 Median $446.68 Typical High $676.08 | Professional | None | $309.03 | $446.68 | $676.08 |
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 $147.91 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $147.91 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $58.88 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $281.84 Typical High $309.03 | Professional | 54 · Surgery only | $223.87 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $56.23 Typical High $61.66 | Professional | 55 · Aftercare only | $44.67 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $29.51 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $263.03 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $208.93 | $263.03 | $288.40 |
Where Indiana sits
The same service costs 6.0 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· 37th of 51
$417
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.