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 $177.83 Median $1,380.38 Typical High $5,011.87 | Facility | None | $177.83 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $354.81 | Professional | None | $177.83 | $309.03 | $354.81 |
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 $173.78 Median $218.78 Typical High $363.08 | Professional | None | $173.78 | $218.78 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $831.76 Typical High $1,230.27 | Facility | None | $213.80 | $831.76 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $575.44 | Professional | None | $165.96 | $281.84 | $575.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $125.89 Median $912.01 Typical High $2,187.76 | Facility | None | $125.89 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $537.03 | Professional | None | $208.93 | $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 $204.17 Median $346.74 Typical High $575.44 | Professional | None | $204.17 | $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 $89.13 Median $154.88 Typical High $177.83 | Professional | 52 · Reduced service | $89.13 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $61.66 Typical High $70.79 | Professional | 53 · Discontinued | $35.48 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $229.09 Typical High $263.03 | Professional | 54 · Surgery only | $134.90 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $45.71 Typical High $52.48 | Professional | 55 · Aftercare only | $26.92 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $30.90 Typical High $35.48 | Professional | 56 · Pre-op care only | $17.78 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $213.80 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $125.89 | $213.80 | $245.47 |
Where Indiana sits
The same service costs 4.6 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· 46th of 51
$263
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.