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 $109.65 Median $3,801.89 Typical High $5,623.41 | Facility | None | $109.65 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $173.78 | Professional | None | $109.65 | $141.25 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $89.13 Median $138.04 Typical High $213.80 | Professional | None | $89.13 | $138.04 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $190.55 | Facility | None | $112.20 | $112.20 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $199.53 Typical High $794.33 | Facility | None | $120.23 | $199.53 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $239.88 | Professional | None | $112.20 | $158.49 | $239.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $177.83 Median $389.05 Typical High $2,187.76 | Facility | None | $177.83 | $389.05 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $245.47 | Professional | None | $128.82 | $181.97 | $245.47 |
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 $102.33 Median $138.04 Typical High $218.78 | Professional | None | $102.33 | $138.04 | $218.78 |
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 $53.70 Median $69.18 Typical High $75.86 | Professional | 52 · Reduced service | $53.70 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.18 Typical High $30.90 | Professional | 53 · Discontinued | $21.88 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $104.71 Typical High $114.82 | Professional | 54 · Surgery only | $81.28 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $22.91 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.80 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.96 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $97.72 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $75.86 | $97.72 | $107.15 |
Where Indiana sits
The same service costs 4.0 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· 35th of 51
$145
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.