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 $1,122.02 Median $1,122.02 Typical High $1,445.44 | Facility | None | $1,122.02 | $1,122.02 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,288.25 | $1,513.56 |
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 $1,000.00 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,905.46 | $2,290.87 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,548.82 | Facility | None | $1,230.27 | $1,230.27 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $2,290.87 | Facility | None | $630.96 | $1,288.25 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $3,630.78 | Professional | None | $1,288.25 | $1,819.70 | $3,630.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $4,677.35 | Facility | None | $1,148.15 | $2,089.30 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $3,090.30 | Professional | None | $1,348.96 | $2,137.96 | $3,090.30 |
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 $1,148.15 Median $1,621.81 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,621.81 | $2,818.38 |
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 $562.34 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $562.34 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $257.04 Typical High $302.00 | Professional | 53 · Discontinued | $223.87 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $194.98 Typical High $223.87 | Professional | 55 · Aftercare only | $169.82 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $112.20 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $912.01 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $794.33 | $912.01 | $1,047.13 |
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· 33rd of 51
$1,738
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.