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 $199.53 Median $2,344.23 Typical High $5,623.41 | Facility | None | $199.53 | $2,344.23 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $295.12 | Professional | None | $199.53 | $275.42 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,162.28 Typical High $5,888.44 | Facility | None | $616.60 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $331.13 | Professional | None | $162.18 | $229.09 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $562.34 | Facility | None | $204.17 | $204.17 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $436.52 Typical High $831.76 | Facility | None | $295.12 | $436.52 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $436.52 | Professional | None | $234.42 | $288.40 | $436.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $1,905.46 | Facility | None | $457.09 | $741.31 | $1,905.46 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $512.86 | Professional | None | $251.19 | $363.08 | $512.86 |
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 $218.78 Median $331.13 Typical High $588.84 | Professional | None | $218.78 | $331.13 | $588.84 |
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 $100.00 Median $138.04 Typical High $147.91 | Professional | 52 · Reduced service | $100.00 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $54.95 Typical High $58.88 | Professional | 53 · Discontinued | $39.81 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $208.93 Typical High $223.87 | Professional | 54 · Surgery only | $147.91 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $41.69 Typical High $44.67 | Professional | 55 · Aftercare only | $29.51 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $27.54 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.95 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $194.98 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $138.04 | $194.98 | $208.93 |
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· 49th of 51
$269
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.