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 $109.65 Median $3,801.89 Typical High $5,623.41 | Facility | None | $109.65 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $208.93 | Professional | None | $109.65 | $162.18 | $208.93 |
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 $58.88 Median $69.18 Typical High $104.71 | Professional | None | $58.88 | $69.18 | $104.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $104.71 Typical High $158.49 | Professional | 50 · Both sides | $89.13 | $104.71 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $257.04 | Facility | None | $109.65 | $109.65 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $199.53 Typical High $338.84 | Facility | None | $66.07 | $199.53 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $162.18 Typical High $275.42 | Professional | None | $89.13 | $162.18 | $275.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $199.53 Median $323.59 Typical High $954.99 | Facility | None | $199.53 | $323.59 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $316.23 | Professional | None | $120.23 | $204.17 | $316.23 |
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 $100.00 Median $169.82 Typical High $295.12 | Professional | None | $100.00 | $169.82 | $295.12 |
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 $53.70 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $53.70 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $41.69 | Professional | 53 · Discontinued | $21.88 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $120.23 Typical High $154.88 | Professional | 54 · Surgery only | $81.28 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $16.22 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.22 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.96 | $16.22 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $112.20 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $75.86 | $112.20 | $144.54 |
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
$151
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.