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 $691.83 Median $4,786.30 Typical High $17,782.79 | Facility | None | $691.83 | $4,786.30 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,288.25 Typical High $1,584.89 | Professional | None | $691.83 | $1,288.25 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,737.80 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $1,047.13 Typical High $1,258.93 | Professional | None | $630.96 | $1,047.13 | $1,258.93 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $7,762.47 | Facility | None | $758.58 | $758.58 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,630.78 Typical High $6,309.57 | Facility | None | $954.99 | $3,630.78 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $2,754.23 | Professional | None | $776.25 | $1,023.29 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,905.46 Median $4,677.35 Typical High $9,549.93 | Facility | None | $1,905.46 | $4,677.35 | $9,549.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $831.76 Median $1,584.89 Typical High $3,090.30 | Professional | None | $831.76 | $1,584.89 | $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 $676.08 Median $1,380.38 Typical High $2,454.71 | Professional | None | $676.08 | $1,380.38 | $2,454.71 |
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 $346.74 Median $645.65 Typical High $794.33 | Professional | 52 · Reduced service | $346.74 | $645.65 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $257.04 Typical High $316.23 | Professional | 53 · Discontinued | $138.04 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $954.99 Typical High $1,202.26 | Professional | 54 · Surgery only | $524.81 | $954.99 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $190.55 Typical High $239.88 | Professional | 55 · Aftercare only | $104.71 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $128.82 Typical High $158.49 | Professional | 56 · Pre-op care only | $69.18 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $891.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $489.78 | $891.25 | $1,122.02 |
Where Indiana sits
The same service costs 4.9 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· 47th of 51
$1,047
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.