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 $120.23 Median $3,801.89 Typical High $5,623.41 | Facility | None | $120.23 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $234.42 Typical High $302.00 | Professional | None | $120.23 | $234.42 | $302.00 |
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 $102.33 Median $128.82 Typical High $186.21 | Professional | None | $102.33 | $128.82 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $257.04 | Facility | None | $123.03 | $123.03 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $177.83 Typical High $346.74 | Facility | None | $66.07 | $177.83 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $338.84 | Professional | None | $123.03 | $190.55 | $338.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $954.99 | Facility | None | $199.53 | $331.13 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $131.83 Median $245.47 Typical High $436.52 | Professional | None | $131.83 | $245.47 | $436.52 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $389.05 | Professional | None | $112.20 | $199.53 | $389.05 |
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 $60.26 Median $117.49 Typical High $147.91 | Professional | 52 · Reduced service | $60.26 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $46.77 Typical High $60.26 | Professional | 53 · Discontinued | $23.99 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $173.78 Typical High $223.87 | Professional | 54 · Surgery only | $89.13 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $34.67 Typical High $44.67 | Professional | 55 · Aftercare only | $17.78 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $23.44 Typical High $29.51 | Professional | 56 · Pre-op care only | $12.02 | $23.44 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $162.18 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $83.18 | $162.18 | $208.93 |
Where Indiana sits
The same service costs 3.6 times more in Wisconsin 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· 48th of 51
$178
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.