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 $128.82 Median $5,011.87 Typical High $7,244.36 | Facility | None | $128.82 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $234.42 | Professional | None | $128.82 | $190.55 | $234.42 |
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 $131.83 Median $194.98 Typical High $281.84 | Professional | None | $131.83 | $194.98 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $295.12 | Facility | None | $154.88 | $154.88 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $288.40 Typical High $794.33 | Facility | None | $173.78 | $288.40 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $338.84 | Professional | None | $144.54 | $213.80 | $338.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $269.15 Median $380.19 Typical High $1,288.25 | Facility | None | $269.15 | $380.19 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $338.84 | Professional | None | $169.82 | $263.03 | $338.84 |
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 $138.04 Median $204.17 Typical High $346.74 | Professional | None | $138.04 | $204.17 | $346.74 |
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 $64.57 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $64.57 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $25.70 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $95.50 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $19.05 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.88 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $125.89 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $89.13 | $125.89 | $151.36 |
Where Indiana sits
The same service costs 3.5 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
$214
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.