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 $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,677.35 | Professional | None | $2,951.21 | $2,951.21 | $4,677.35 |
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 $457.09 Median $537.03 Typical High $724.44 | Professional | None | $457.09 | $537.03 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $5,754.40 | Facility | None | $2,884.03 | $2,884.03 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,290.87 Typical High $3,235.94 | Facility | None | $630.96 | $2,290.87 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $4,265.80 Typical High $25,703.96 | Professional | None | $870.96 | $4,265.80 | $25,703.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,162.28 Typical High $7,943.28 | Facility | None | $954.99 | $3,162.28 | $7,943.28 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $85.11 Median $1,096.48 Typical High $1,288.25 | Professional | None | $85.11 | $1,096.48 | $1,288.25 |
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 $1,778.28 Median $2,884.03 Typical High $5,495.41 | Professional | None | $1,778.28 | $2,884.03 | $5,495.41 |
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 $1,479.11 Median $1,479.11 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,479.11 | $1,479.11 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $588.84 Typical High $933.25 | Professional | 53 · Discontinued | $588.84 | $588.84 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $691.83 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $295.12 Typical High $467.74 | Professional | 56 · Pre-op care only | $295.12 | $295.12 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $3,235.94 |
Where Indiana sits
The same service costs 21.4 times more in Alaska than in Kentucky. 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· 45th of 51
$1,778
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.