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 $87.10 Median $3,801.89 Typical High $5,623.41 | Facility | None | $87.10 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $186.21 | Professional | None | $87.10 | $138.04 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $89.13 Median $144.54 Typical High $169.82 | Professional | None | $89.13 | $144.54 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $218.78 | Facility | None | $107.15 | $107.15 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $165.96 Typical High $281.84 | Facility | None | $66.07 | $165.96 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $223.87 | Professional | None | $97.72 | $144.54 | $223.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $169.82 Median $275.42 Typical High $954.99 | Facility | None | $169.82 | $275.42 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $229.09 | Professional | None | $109.65 | $173.78 | $229.09 |
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 $95.50 Median $141.25 Typical High $239.88 | Professional | None | $95.50 | $141.25 | $239.88 |
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 $43.65 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $43.65 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $25.12 Typical High $30.20 | Professional | 53 · Discontinued | $17.38 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $66.07 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $13.18 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.71 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $87.10 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $61.66 | $87.10 | $107.15 |
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· 33rd of 51
$151
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.