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 $117.49 Median $3,467.37 Typical High $5,623.41 | Facility | None | $117.49 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $154.88 | Professional | None | $114.82 | $125.89 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $3,162.28 Typical High $5,888.44 | Facility | None | $602.56 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $204.17 | Professional | None | $109.65 | $147.91 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $295.12 | Facility | None | $128.82 | $128.82 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $288.40 Typical High $512.86 | Facility | None | $162.18 | $288.40 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $338.84 | Professional | None | $131.83 | $169.82 | $338.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $269.15 Median $416.87 Typical High $954.99 | Facility | None | $269.15 | $416.87 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $288.40 | Professional | None | $138.04 | $208.93 | $288.40 |
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 $112.20 Median $147.91 Typical High $263.03 | Professional | None | $112.20 | $147.91 | $263.03 |
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 $58.88 Median $64.57 Typical High $72.44 | Professional | 52 · Reduced service | $58.88 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.70 Typical High $29.51 | Professional | 53 · Discontinued | $23.44 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $95.50 Typical High $109.65 | Professional | 54 · Surgery only | $89.13 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.05 Typical High $21.88 | Professional | 55 · Aftercare only | $17.78 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.88 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.75 | $12.88 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $89.13 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $83.18 | $89.13 | $102.33 |
Where Indiana sits
The same service costs 3.8 times more in Alaska than in Delaware. 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· 40th of 51
$148
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.