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 $141.25 Median $3,801.89 Typical High $5,623.41 | Facility | None | $141.25 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $223.87 | Professional | None | $141.25 | $199.53 | $223.87 |
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 $144.54 Median $208.93 Typical High $295.12 | Professional | None | $144.54 | $208.93 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $295.12 | Facility | None | $169.82 | $169.82 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $275.42 Typical High $724.44 | Facility | None | $173.78 | $275.42 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $338.84 | Professional | None | $154.88 | $218.78 | $338.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $269.15 Median $416.87 Typical High $1,288.25 | Facility | None | $269.15 | $416.87 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $363.08 | Professional | None | $186.21 | $269.15 | $363.08 |
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 $151.36 Median $223.87 Typical High $363.08 | Professional | None | $151.36 | $223.87 | $363.08 |
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 $70.79 Median $100.00 Typical High $112.20 | Professional | 52 · Reduced service | $70.79 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $39.81 Typical High $44.67 | Professional | 53 · Discontinued | $28.18 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $147.91 Typical High $165.96 | Professional | 54 · Surgery only | $104.71 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $20.89 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.95 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.13 | $19.95 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $138.04 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $97.72 | $138.04 | $154.88 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Texas. 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
$224
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.