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 $436.52 Median $3,467.37 Typical High $7,244.36 | Facility | None | $436.52 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $724.44 | Professional | None | $436.52 | $562.34 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $10,964.78 Typical High $22,908.68 | Facility | None | $758.58 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $588.84 | Professional | None | $316.23 | $446.68 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $7,762.47 | Facility | None | $436.52 | $436.52 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,890.45 Typical High $6,606.93 | Facility | None | $549.54 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $588.84 Typical High $1,202.26 | Professional | None | $263.03 | $588.84 | $1,202.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $9,332.54 | Facility | None | $977.24 | $4,570.88 | $9,332.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,348.96 | Professional | None | $524.81 | $891.25 | $1,348.96 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $323.59 Median $562.34 Typical High $1,047.13 | Professional | None | $323.59 | $562.34 | $1,047.13 |
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 $218.78 Median $275.42 Typical High $363.08 | Professional | 52 · Reduced service | $218.78 | $275.42 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $112.20 Typical High $144.54 | Professional | 53 · Discontinued | $87.10 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $416.87 Typical High $537.03 | Professional | 54 · Surgery only | $323.59 | $416.87 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $83.18 Typical High $107.15 | Professional | 55 · Aftercare only | $64.57 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $56.23 Typical High $72.44 | Professional | 56 · Pre-op care only | $43.65 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $389.05 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $302.00 | $389.05 | $501.19 |
Where Indiana sits
The same service costs 5.9 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· 46th of 51
$525
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.