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 $229.09 Median $3,801.89 Typical High $5,623.41 | Facility | None | $229.09 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $380.19 | Professional | None | $229.09 | $288.40 | $380.19 |
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 $223.87 Median $309.03 Typical High $457.09 | Professional | None | $223.87 | $309.03 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $426.58 | Facility | None | $281.84 | $281.84 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $794.33 | Facility | None | $251.19 | $407.38 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $549.54 | Professional | None | $263.03 | $354.81 | $549.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $316.23 Median $575.44 Typical High $1,288.25 | Facility | None | $316.23 | $575.44 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $602.56 | Professional | None | $281.84 | $389.05 | $602.56 |
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 $234.42 Median $323.59 Typical High $512.86 | Professional | None | $234.42 | $323.59 | $512.86 |
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 $114.82 Median $141.25 Typical High $158.49 | Professional | 52 · Reduced service | $114.82 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $56.23 Typical High $63.10 | Professional | 53 · Discontinued | $45.71 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $213.80 Typical High $234.42 | Professional | 54 · Surgery only | $173.78 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $42.66 Typical High $46.77 | Professional | 55 · Aftercare only | $34.67 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.18 Typical High $31.62 | Professional | 56 · Pre-op care only | $22.91 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $199.53 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $162.18 | $199.53 | $218.78 |
Where Indiana sits
The same service costs 4.7 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· 34th of 51
$339
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.