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 $213.80 Median $478.63 Typical High $5,623.41 | Facility | None | $213.80 | $478.63 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $263.03 | Professional | None | $144.54 | $208.93 | $263.03 |
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 $134.90 Median $169.82 Typical High $223.87 | Professional | None | $134.90 | $169.82 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $1,479.11 | Facility | None | $158.49 | $158.49 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,096.48 Typical High $1,659.59 | Facility | None | $407.38 | $1,096.48 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $436.52 | Professional | None | $141.25 | $218.78 | $436.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $426.58 Median $1,548.82 Typical High $2,344.23 | Facility | None | $426.58 | $1,548.82 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $501.19 | Professional | None | $165.96 | $309.03 | $501.19 |
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 $138.04 Median $229.09 Typical High $389.05 | Professional | None | $138.04 | $229.09 | $389.05 |
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 $72.44 Median $104.71 Typical High $131.83 | Professional | 52 · Reduced service | $72.44 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $41.69 Typical High $52.48 | Professional | 53 · Discontinued | $29.51 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $158.49 Typical High $194.98 | Professional | 54 · Surgery only | $109.65 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $21.88 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.89 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.45 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $147.91 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $102.33 | $147.91 | $186.21 |
Where Indiana sits
The same service costs 4.5 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· 49th of 51
$200
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.