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 $144.54 Median $1,380.38 Typical High $5,011.87 | Facility | None | $144.54 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $229.09 | Professional | None | $144.54 | $208.93 | $229.09 |
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 $114.82 Median $169.82 Typical High $245.47 | Professional | None | $114.82 | $169.82 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $257.04 | Facility | None | $147.91 | $147.91 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $204.17 Typical High $346.74 | Facility | None | $66.07 | $204.17 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $331.13 | Professional | None | $165.96 | $208.93 | $331.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $199.53 Median $338.84 Typical High $954.99 | Facility | None | $199.53 | $338.84 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $389.05 | Professional | None | $181.97 | $269.15 | $389.05 |
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 $154.88 Median $251.19 Typical High $436.52 | Professional | None | $154.88 | $251.19 | $436.52 |
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 $72.44 Median $104.71 Typical High $112.20 | Professional | 52 · Reduced service | $72.44 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $41.69 Typical High $45.71 | Professional | 53 · Discontinued | $28.84 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $158.49 Typical High $169.82 | Professional | 54 · Surgery only | $107.15 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $31.62 Typical High $33.88 | Professional | 55 · Aftercare only | $21.38 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.89 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.45 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $147.91 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $100.00 | $147.91 | $158.49 |
Where Indiana sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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
$200
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.