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 $97.72 Median $3,801.89 Typical High $5,623.41 | Facility | None | $97.72 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $208.93 | Professional | None | $97.72 | $147.91 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | None | $147.91 | $147.91 | $165.96 |
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 $100.00 Median $151.36 Typical High $213.80 | Professional | None | $100.00 | $151.36 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $218.78 | Facility | None | $120.23 | $120.23 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $169.82 Typical High $288.40 | Facility | None | $66.07 | $169.82 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $251.19 | Professional | None | $109.65 | $158.49 | $251.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $199.53 Median $288.40 Typical High $954.99 | Facility | None | $199.53 | $288.40 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $257.04 | Professional | None | $128.82 | $199.53 | $257.04 |
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 $107.15 Median $154.88 Typical High $263.03 | Professional | None | $107.15 | $154.88 | $263.03 |
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 $48.98 Median $69.18 Typical High $81.28 | Professional | 52 · Reduced service | $48.98 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $28.18 Typical High $33.11 | Professional | 53 · Discontinued | $19.95 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $104.71 Typical High $123.03 | Professional | 54 · Surgery only | $74.13 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $20.89 Typical High $24.55 | Professional | 55 · Aftercare only | $14.79 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.13 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.77 | $14.13 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $97.72 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $69.18 | $97.72 | $114.82 |
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
$162
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.