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 $141.25 Median $229.09 Typical High $1,380.38 | Facility | None | $141.25 | $229.09 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $257.04 | Professional | None | $123.03 | $190.55 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $269.15 | Professional | None | $151.36 | $151.36 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $3,162.28 Typical High $6,309.57 | Facility | None | $549.54 | $3,162.28 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $154.88 | Professional | None | $91.20 | $109.65 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $616.60 Typical High $912.01 | Facility | None | $120.23 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $173.78 Typical High $380.19 | Professional | None | $87.10 | $173.78 | $380.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $186.21 Median $416.87 Typical High $2,089.30 | Facility | None | $186.21 | $416.87 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $346.74 | Professional | None | $134.90 | $229.09 | $346.74 |
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 $109.65 Median $190.55 Typical High $316.23 | Professional | None | $109.65 | $190.55 | $316.23 |
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 $61.66 Median $91.20 Typical High $117.49 | Professional | 52 · Reduced service | $61.66 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $36.31 Typical High $46.77 | Professional | 53 · Discontinued | $24.55 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $138.04 Typical High $173.78 | Professional | 54 · Surgery only | $91.20 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $18.20 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.20 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.30 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $128.82 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $85.11 | $128.82 | $162.18 |
Where Indiana sits
The same service costs 4.5 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· 46th of 51
$166
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.