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 $109.65 Median $3,801.89 Typical High $5,623.41 | Facility | None | $109.65 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $194.98 | Professional | None | $109.65 | $169.82 | $194.98 |
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 $112.20 Median $173.78 Typical High $251.19 | Professional | None | $112.20 | $173.78 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $269.15 | Facility | None | $131.83 | $131.83 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $199.53 Typical High $346.74 | Facility | None | $66.07 | $199.53 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $288.40 | Professional | None | $123.03 | $186.21 | $288.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $245.47 Median $338.84 Typical High $1,288.25 | Facility | None | $245.47 | $338.84 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $288.40 | Professional | None | $144.54 | $229.09 | $288.40 |
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 $117.49 Median $177.83 Typical High $302.00 | Professional | None | $117.49 | $177.83 | $302.00 |
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 $54.95 Median $79.43 Typical High $93.33 | Professional | 52 · Reduced service | $54.95 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $31.62 Typical High $38.02 | Professional | 53 · Discontinued | $21.88 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $117.49 Typical High $141.25 | Professional | 54 · Surgery only | $81.28 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $23.44 Typical High $28.18 | Professional | 55 · Aftercare only | $16.22 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.96 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $109.65 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $75.86 | $109.65 | $131.83 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 37th of 51
$186
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.