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 $117.49 Median $3,467.37 Typical High $5,623.41 | Facility | None | $117.49 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $239.88 | Professional | None | $117.49 | $208.93 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $3,162.28 Typical High $5,888.44 | Facility | None | $602.56 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $213.80 | Professional | None | $91.20 | $158.49 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $257.04 | Facility | None | $117.49 | $117.49 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $257.04 Typical High $794.33 | Facility | None | $154.88 | $257.04 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $316.23 | Professional | None | $114.82 | $169.82 | $316.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $954.99 | Facility | None | $199.53 | $331.13 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $380.19 | Professional | None | $138.04 | $234.42 | $380.19 |
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 $186.21 Typical High $302.00 | Professional | None | $109.65 | $186.21 | $302.00 |
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 $58.88 Median $102.33 Typical High $120.23 | Professional | 52 · Reduced service | $58.88 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $41.69 Typical High $47.86 | Professional | 53 · Discontinued | $23.44 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $154.88 Typical High $177.83 | Professional | 54 · Surgery only | $89.13 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $17.78 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $11.75 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $144.54 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $83.18 | $144.54 | $165.96 |
Where Indiana sits
The same service costs 3.5 times more in Alaska 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· 42nd of 51
$174
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.