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 $194.98 Median $2,344.23 Typical High $5,623.41 | Facility | None | $194.98 | $2,344.23 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $281.84 | Professional | None | $162.18 | $208.93 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $288.40 | Professional | None | $128.82 | $218.78 | $288.40 |
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 $165.96 Median $194.98 Typical High $257.04 | Professional | None | $165.96 | $194.98 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $269.15 | Facility | None | $208.93 | $208.93 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $288.40 | Professional | None | $199.53 | $223.87 | $288.40 |
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 $199.53 Median $245.47 Typical High $457.09 | Professional | None | $199.53 | $245.47 | $457.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $575.44 Typical High $954.99 | Facility | None | $229.09 | $575.44 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $457.09 | Professional | None | $234.42 | $316.23 | $457.09 |
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 $165.96 Median $208.93 Typical High $380.19 | Professional | None | $165.96 | $208.93 | $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 $91.20 Median $102.33 Typical High $109.65 | Professional | 52 · Reduced service | $91.20 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $40.74 Typical High $43.65 | Professional | 53 · Discontinued | $36.31 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $154.88 Typical High $162.18 | Professional | 54 · Surgery only | $134.90 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.90 Typical High $32.36 | Professional | 55 · Aftercare only | $27.54 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.42 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.20 | $20.42 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $144.54 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $125.89 | $144.54 | $151.36 |
Where Indiana sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$209
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.