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 $72.44 Median $3,801.89 Typical High $5,623.41 | Facility | None | $72.44 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $154.88 | Professional | None | $72.44 | $114.82 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
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 $74.13 Median $117.49 Typical High $169.82 | Professional | None | $74.13 | $117.49 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $912.01 | Facility | None | $89.13 | $616.60 | $912.01 |
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 $81.28 Median $125.89 Typical High $199.53 | Professional | None | $81.28 | $125.89 | $199.53 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $213.80 Median $380.19 Typical High $2,089.30 | Facility | None | $213.80 | $380.19 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $194.98 | Professional | None | $95.50 | $151.36 | $194.98 |
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 $77.62 Median $120.23 Typical High $199.53 | Professional | None | $77.62 | $120.23 | $199.53 |
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 $36.31 Median $53.70 Typical High $63.10 | Professional | 52 · Reduced service | $36.31 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $21.38 Typical High $25.70 | Professional | 53 · Discontinued | $14.45 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $81.28 Typical High $95.50 | Professional | 54 · Surgery only | $53.70 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $16.22 Typical High $19.05 | Professional | 55 · Aftercare only | $10.72 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.72 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.24 | $10.72 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $75.86 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $50.12 | $75.86 | $89.13 |
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
$123
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.