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 $58.88 Median $3,801.89 Typical High $5,623.41 | Facility | None | $58.88 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $100.00 | Professional | None | $58.88 | $81.28 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
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 $58.88 Median $89.13 Typical High $112.20 | Professional | None | $58.88 | $89.13 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $616.60 Typical High $912.01 | Facility | None | $70.79 | $616.60 | $912.01 |
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 $66.07 Median $95.50 Typical High $151.36 | Professional | None | $66.07 | $95.50 | $151.36 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $169.82 Median $288.40 Typical High $2,089.30 | Facility | None | $169.82 | $288.40 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $154.88 | Professional | None | $70.79 | $112.20 | $154.88 |
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 $60.26 Median $87.10 Typical High $144.54 | Professional | None | $60.26 | $87.10 | $144.54 |
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 $29.51 Median $40.74 Typical High $45.71 | Professional | 52 · Reduced service | $29.51 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.22 Typical High $18.20 | Professional | 53 · Discontinued | $11.75 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $60.26 Typical High $69.18 | Professional | 54 · Surgery only | $44.67 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.02 Typical High $13.80 | Professional | 55 · Aftercare only | $8.91 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.13 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.89 | $8.13 | $9.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $41.69 Median $56.23 Typical High $64.57 | Professional | 78 · Unplanned return to OR | $41.69 | $56.23 | $64.57 |
Where Indiana sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 41st of 51
$91.20
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.