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 $147.91 Median $288.40 Typical High $5,248.07 | Facility | None | $147.91 | $288.40 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $245.47 | Professional | None | $114.82 | $186.21 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $6,165.95 | Facility | None | $616.60 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $186.21 | Professional | None | $104.71 | $128.82 | $186.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $194.98 Typical High $275.42 | Professional | 50 · Both sides | $154.88 | $194.98 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $331.13 | Facility | None | $134.90 | $134.90 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $794.33 | Facility | None | $199.53 | $331.13 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $501.19 | Professional | None | $147.91 | $251.19 | $501.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $295.12 Median $426.58 Typical High $2,089.30 | Facility | None | $295.12 | $426.58 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $467.74 | Professional | None | $147.91 | $275.42 | $467.74 |
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 $117.49 Median $213.80 Typical High $371.54 | Professional | None | $117.49 | $213.80 | $371.54 |
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 $61.66 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $61.66 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $25.12 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $141.25 Typical High $173.78 | Professional | 54 · Surgery only | $93.33 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $28.18 Typical High $34.67 | Professional | 55 · Aftercare only | $18.62 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.59 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $131.83 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $87.10 | $131.83 | $162.18 |
Where Indiana sits
The same service costs 3.6 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
$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.