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 $77.62 Median $1,380.38 Typical High $5,011.87 | Facility | None | $77.62 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $114.82 | Professional | None | $77.62 | $102.33 | $114.82 |
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 $81.28 Median $112.20 Typical High $162.18 | Professional | None | $81.28 | $112.20 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $616.60 Typical High $912.01 | Facility | None | $95.50 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $112.20 Typical High $257.04 | Facility | None | $50.12 | $112.20 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $177.83 | Professional | None | $87.10 | $114.82 | $177.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $218.78 Median $338.84 Typical High $2,089.30 | Facility | None | $218.78 | $338.84 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $199.53 | Professional | None | $91.20 | $134.90 | $199.53 |
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 $81.28 Median $117.49 Typical High $186.21 | Professional | None | $81.28 | $117.49 | $186.21 |
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 $38.90 Median $51.29 Typical High $57.54 | Professional | 52 · Reduced service | $38.90 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $20.42 Typical High $22.91 | Professional | 53 · Discontinued | $15.49 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $77.62 Typical High $85.11 | Professional | 54 · Surgery only | $58.88 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $15.49 Typical High $16.98 | Professional | 55 · Aftercare only | $11.75 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.23 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.76 | $10.23 | $11.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $72.44 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $54.95 | $72.44 | $79.43 |
Where Indiana sits
The same service costs 3.8 times more in Alaska than in New York. 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
$115
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.