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 $128.82 Median $3,801.89 Typical High $5,623.41 | Facility | None | $128.82 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $251.19 | Professional | None | $128.82 | $208.93 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $218.78 | Professional | None | $114.82 | $114.82 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $208.93 | Professional | None | $95.50 | $147.91 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $338.84 | Facility | None | $128.82 | $128.82 | $338.84 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $338.84 Typical High $794.33 | Facility | None | $204.17 | $338.84 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $316.23 | Professional | None | $128.82 | $190.55 | $316.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $323.59 Median $616.60 Typical High $4,677.35 | Facility | None | $323.59 | $616.60 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $380.19 | Professional | None | $151.36 | $245.47 | $380.19 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $302.00 | Professional | None | $123.03 | $190.55 | $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 $64.57 Median $104.71 Typical High $114.82 | Professional | 52 · Reduced service | $64.57 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $41.69 Typical High $46.77 | Professional | 53 · Discontinued | $25.70 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $158.49 Typical High $173.78 | Professional | 54 · Surgery only | $95.50 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $31.62 Typical High $34.67 | Professional | 55 · Aftercare only | $19.05 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.89 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.88 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $147.91 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $89.13 | $147.91 | $162.18 |
Where Indiana sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 45th 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.