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 $144.54 Median $3,801.89 Typical High $5,623.41 | Facility | None | $144.54 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $251.19 | Professional | None | $144.54 | $204.17 | $251.19 |
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 $131.83 Median $186.21 Typical High $239.88 | Professional | None | $131.83 | $186.21 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $346.74 | Facility | None | $158.49 | $158.49 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $794.33 | Facility | None | $223.87 | $363.08 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $446.68 | Professional | None | $138.04 | $223.87 | $446.68 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $331.13 Median $489.78 Typical High $2,344.23 | Facility | None | $331.13 | $489.78 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $478.63 | Professional | None | $169.82 | $302.00 | $478.63 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $380.19 | Professional | None | $138.04 | $223.87 | $380.19 |
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 $102.33 Typical High $125.89 | Professional | 52 · Reduced service | $72.44 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $40.74 Typical High $50.12 | Professional | 53 · Discontinued | $28.84 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $151.36 Typical High $190.55 | Professional | 54 · Surgery only | $109.65 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $30.20 Typical High $38.02 | Professional | 55 · Aftercare only | $21.88 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.42 Typical High $25.12 | Professional | 56 · Pre-op care only | $14.45 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $141.25 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $102.33 | $141.25 | $177.83 |
Where Indiana sits
The same service costs 4.4 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· 46th of 51
$204
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.