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 $138.04 Median $1,380.38 Typical High $7,244.36 | Facility | None | $138.04 | $1,380.38 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $229.09 | Professional | None | $123.03 | $147.91 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $245.47 | Professional | None | $117.49 | $190.55 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $295.12 | Facility | None | $151.36 | $151.36 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $316.23 Typical High $794.33 | Facility | None | $190.55 | $316.23 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $407.38 | Professional | None | $151.36 | $223.87 | $407.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $263.03 Median $416.87 Typical High $2,344.23 | Facility | None | $263.03 | $416.87 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $416.87 | Professional | None | $165.96 | $288.40 | $416.87 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $323.59 | Professional | None | $128.82 | $186.21 | $323.59 |
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 $69.18 Median $87.10 Typical High $107.15 | Professional | 52 · Reduced service | $69.18 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $34.67 Typical High $42.66 | Professional | 53 · Discontinued | $27.54 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $131.83 Typical High $158.49 | Professional | 54 · Surgery only | $102.33 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $26.30 Typical High $32.36 | Professional | 55 · Aftercare only | $20.42 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $17.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.80 | $17.38 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $123.03 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $95.50 | $123.03 | $147.91 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 37th of 51
$204
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.