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 $141.25 Median $3,801.89 Typical High $5,623.41 | Facility | None | $141.25 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $234.42 | Professional | None | $141.25 | $208.93 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $269.15 Typical High $323.59 | Professional | None | $131.83 | $269.15 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $309.03 | Facility | None | $141.25 | $141.25 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $316.23 Typical High $549.54 | Facility | None | $181.97 | $316.23 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $371.54 | Professional | None | $147.91 | $229.09 | $371.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $295.12 Median $602.56 Typical High $4,677.35 | Facility | None | $295.12 | $602.56 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $371.54 | Professional | None | $165.96 | $263.03 | $371.54 |
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 $138.04 Median $208.93 Typical High $338.84 | Professional | None | $138.04 | $208.93 | $338.84 |
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 $70.79 Median $104.71 Typical High $117.49 | Professional | 52 · Reduced service | $70.79 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $46.77 | Professional | 53 · Discontinued | $28.18 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $173.78 | Professional | 54 · Surgery only | $107.15 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.89 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.13 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $162.18 |
Where Indiana sits
The same service costs 3.5 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· 28th of 51
$234
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.