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 $114.82 Median $3,801.89 Typical High $5,623.41 | Facility | None | $114.82 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $154.88 | Professional | None | $91.20 | $114.82 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $181.97 | Professional | None | $114.82 | $114.82 | $181.97 |
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 $97.72 Median $114.82 Typical High $151.36 | Professional | None | $97.72 | $114.82 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $165.96 | Facility | None | $125.89 | $125.89 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $134.90 Typical High $229.09 | Facility | None | $66.07 | $134.90 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $269.15 | Professional | None | $117.49 | $144.54 | $269.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $169.82 Median $354.81 Typical High $954.99 | Facility | None | $169.82 | $354.81 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $257.04 | Professional | None | $134.90 | $186.21 | $257.04 |
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 $95.50 Median $120.23 Typical High $213.80 | Professional | None | $95.50 | $120.23 | $213.80 |
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 $57.54 Median $57.54 Typical High $60.26 | Professional | 52 · Reduced service | $57.54 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $23.99 | Professional | 53 · Discontinued | $22.91 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | 54 · Surgery only | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $18.20 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $79.43 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $79.43 | $79.43 | $83.18 |
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· 41st of 51
$123
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.