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 $181.97 Median $3,801.89 Typical High $5,623.41 | Facility | None | $181.97 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $229.09 | Professional | None | $162.18 | $194.98 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $251.19 | Professional | None | $154.88 | $181.97 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Facility | None | $199.53 | $199.53 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $208.93 Typical High $354.81 | Facility | None | $66.07 | $208.93 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $436.52 | Professional | None | $194.98 | $245.47 | $436.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $549.54 Typical High $954.99 | Facility | None | $229.09 | $549.54 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $446.68 | Professional | None | $218.78 | $309.03 | $446.68 |
United Setting Facility Modifier None Typical Low $109.65 Median $851.14 Typical High $4,168.69 | Facility | None | $109.65 | $851.14 | $4,168.69 |
United Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $363.08 | Professional | None | $162.18 | $204.17 | $363.08 |
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 $89.13 Median $95.50 Typical High $104.71 | Professional | 52 · Reduced service | $89.13 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $35.48 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $144.54 Typical High $158.49 | Professional | 54 · Surgery only | $131.83 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $31.62 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $17.78 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $134.90 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $123.03 | $134.90 | $147.91 |
Where Indiana sits
The same service costs 4.8 times more in Alaska than in Florida. 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· 43rd 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.