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 $120.23 Median $309.03 Typical High $5,623.41 | Facility | None | $120.23 | $309.03 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $223.87 | Professional | None | $91.20 | $144.54 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $162.18 | Professional | None | $125.89 | $147.91 | $162.18 |
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 $93.33 Median $154.88 Typical High $194.98 | Professional | None | $93.33 | $154.88 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $112.20 Median $616.60 Typical High $912.01 | Facility | None | $112.20 | $616.60 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $223.87 | Professional | None | $162.18 | $177.83 | $223.87 |
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 $104.71 Median $158.49 Typical High $239.88 | Professional | None | $104.71 | $158.49 | $239.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $263.03 Median $478.63 Typical High $2,089.30 | Facility | None | $263.03 | $478.63 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $251.19 | Professional | None | $114.82 | $190.55 | $251.19 |
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 $100.00 Median $151.36 Typical High $257.04 | Professional | None | $100.00 | $151.36 | $257.04 |
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 $45.71 Median $66.07 Typical High $81.28 | Professional | 52 · Reduced service | $45.71 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.92 Typical High $32.36 | Professional | 53 · Discontinued | $18.62 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $100.00 Typical High $123.03 | Professional | 54 · Surgery only | $69.18 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.95 Typical High $24.55 | Professional | 55 · Aftercare only | $13.80 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $13.49 Typical High $16.22 | Professional | 56 · Pre-op care only | $9.12 | $13.49 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $93.33 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $64.57 | $93.33 | $114.82 |
Where Indiana sits
The same service costs 3.4 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
$158
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.