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 $112.20 Median $1,380.38 Typical High $5,011.87 | Facility | None | $112.20 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $186.21 | Professional | None | $112.20 | $177.83 | $186.21 |
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 $95.50 Median $173.78 Typical High $251.19 | Professional | None | $95.50 | $173.78 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $616.60 Typical High $912.01 | Facility | None | $117.49 | $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 $109.65 Median $181.97 Typical High $302.00 | Professional | None | $109.65 | $181.97 | $302.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $323.59 Median $912.01 Typical High $2,187.76 | Facility | None | $323.59 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $331.13 | Professional | None | $147.91 | $234.42 | $331.13 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $338.84 | Professional | None | $117.49 | $186.21 | $338.84 |
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 $54.95 Median $89.13 Typical High $93.33 | Professional | 52 · Reduced service | $54.95 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $35.48 Typical High $37.15 | Professional | 53 · Discontinued | $22.39 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $131.83 Typical High $141.25 | Professional | 54 · Surgery only | $83.18 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $26.30 Typical High $28.18 | Professional | 55 · Aftercare only | $16.60 | $26.30 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $17.78 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.22 | $17.78 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $123.03 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $77.62 | $123.03 | $131.83 |
Where Indiana sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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
$195
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.