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 $338.84 Median $1,380.38 Typical High $5,011.87 | Facility | None | $338.84 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $489.78 | Professional | None | $338.84 | $436.52 | $489.78 |
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 $371.54 Median $467.74 Typical High $707.95 | Professional | None | $371.54 | $467.74 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $676.08 | Facility | None | $416.87 | $416.87 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $524.81 Typical High $831.76 | Facility | None | $66.07 | $524.81 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $851.14 | Professional | None | $354.81 | $524.81 | $851.14 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $1,995.26 | Facility | None | $512.86 | $870.96 | $1,995.26 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $912.01 | Professional | None | $398.11 | $602.56 | $912.01 |
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 $354.81 Median $512.86 Typical High $794.33 | Professional | None | $354.81 | $512.86 | $794.33 |
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 $169.82 Median $218.78 Typical High $245.47 | Professional | 52 · Reduced service | $169.82 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $87.10 Typical High $97.72 | Professional | 53 · Discontinued | $67.61 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $257.04 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $66.07 Typical High $72.44 | Professional | 55 · Aftercare only | $51.29 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $43.65 Typical High $48.98 | Professional | 56 · Pre-op care only | $33.88 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $239.88 | $309.03 | $338.84 |
Where Indiana sits
The same service costs 5.1 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· 36th of 51
$490
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.