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 $1,258.93 Median $1,258.93 Typical High $1,584.89 | Facility | None | $1,258.93 | $1,258.93 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,412.54 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $2,187.76 Typical High $2,630.27 | Professional | None | $1,096.48 | $2,187.76 | $2,630.27 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,548.82 | Facility | None | $1,380.38 | $1,380.38 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,479.11 Typical High $2,691.53 | Facility | None | $645.65 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $3,890.45 | Professional | None | $1,412.54 | $1,905.46 | $3,890.45 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,174.90 Median $2,089.30 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,089.30 | $4,897.79 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $3,388.44 | Professional | None | $1,479.11 | $2,290.87 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,258.93 | $1,778.28 | $3,019.95 |
5 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 $630.96 Median $707.95 Typical High $812.83 | Professional | 52 · Reduced service | $630.96 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $251.19 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $213.80 Typical High $245.47 | Professional | 55 · Aftercare only | $190.55 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $125.89 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,000.00 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $870.96 | $1,000.00 | $1,148.15 |
Where Indiana sits
The same service costs 5.1 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· 32nd of 51
$1,905
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.