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 $102.33 Median $1,380.38 Typical High $5,011.87 | Facility | None | $102.33 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $169.82 | Professional | None | $102.33 | $131.83 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $138.04 | Professional | None | $79.43 | $97.72 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $218.78 | Facility | None | $104.71 | $104.71 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $229.09 Typical High $794.33 | Facility | None | $138.04 | $229.09 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $218.78 | Professional | None | $89.13 | $147.91 | $218.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $204.17 Median $389.05 Typical High $2,187.76 | Facility | None | $204.17 | $389.05 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $257.04 | Professional | None | $112.20 | $173.78 | $257.04 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $239.88 | Professional | None | $93.33 | $144.54 | $239.88 |
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 $51.29 Median $66.07 Typical High $85.11 | Professional | 52 · Reduced service | $51.29 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.30 Typical High $33.88 | Professional | 53 · Discontinued | $20.42 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $100.00 Typical High $125.89 | Professional | 54 · Surgery only | $75.86 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.95 Typical High $25.12 | Professional | 55 · Aftercare only | $15.14 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.18 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.23 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $93.33 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $70.79 | $93.33 | $117.49 |
Where Indiana sits
The same service costs 4.4 times more in Alaska 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
$141
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.