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 $346.74 Median $1,380.38 Typical High $7,244.36 | Facility | None | $346.74 | $1,380.38 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $457.09 | Professional | None | $346.74 | $380.19 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $346.74 | Professional | None | $204.17 | $239.88 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $2,884.03 | Facility | None | $371.54 | $371.54 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $3,235.94 | Facility | None | $549.54 | $2,137.96 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $954.99 | Professional | None | $275.42 | $457.09 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $2,454.71 Typical High $4,677.35 | Facility | None | $954.99 | $2,454.71 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $389.05 Median $630.96 Typical High $912.01 | Professional | None | $389.05 | $630.96 | $912.01 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $812.83 | Professional | None | $338.84 | $457.09 | $812.83 |
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 $169.82 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $169.82 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $69.18 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $288.40 Typical High $338.84 | Professional | 54 · Surgery only | $257.04 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $67.61 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $34.67 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $269.15 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $239.88 | $269.15 | $316.23 |
Where Indiana sits
The same service costs 6.0 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· 46th of 51
$417
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.