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 $218.78 Median $3,801.89 Typical High $5,623.41 | Facility | None | $218.78 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $363.08 | Professional | None | $218.78 | $323.59 | $363.08 |
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 $213.80 Median $389.05 Typical High $457.09 | Professional | None | $213.80 | $389.05 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $467.74 | Facility | None | $229.09 | $229.09 | $467.74 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $512.86 Typical High $1,479.11 | Facility | None | $309.03 | $512.86 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $512.86 | Professional | None | $229.09 | $295.12 | $512.86 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $426.58 Median $758.58 Typical High $2,187.76 | Facility | None | $426.58 | $758.58 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $588.84 | Professional | None | $257.04 | $407.38 | $588.84 |
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 $208.93 Median $295.12 Typical High $467.74 | Professional | None | $208.93 | $295.12 | $467.74 |
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 $109.65 Median $162.18 Typical High $177.83 | Professional | 52 · Reduced service | $109.65 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $64.57 Typical High $72.44 | Professional | 53 · Discontinued | $43.65 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $245.47 Typical High $269.15 | Professional | 54 · Surgery only | $162.18 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $48.98 Typical High $53.70 | Professional | 55 · Aftercare only | $32.36 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $32.36 Typical High $36.31 | Professional | 56 · Pre-op care only | $21.88 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $229.09 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $151.36 | $229.09 | $251.19 |
Where Indiana sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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· 31st of 51
$347
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.