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 $223.87 Median $3,467.37 Typical High $7,244.36 | Facility | None | $223.87 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $338.84 | Professional | None | $223.87 | $295.12 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $302.00 | Professional | None | $181.97 | $234.42 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $1,348.96 | Facility | None | $229.09 | $229.09 | $1,348.96 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $1,862.09 | Facility | None | $549.54 | $1,000.00 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $457.09 | Professional | None | $234.42 | $316.23 | $457.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $616.60 Median $1,479.11 Typical High $2,754.23 | Facility | None | $616.60 | $1,479.11 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $501.19 | Professional | None | $251.19 | $380.19 | $501.19 |
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 $213.80 Median $288.40 Typical High $457.09 | Professional | None | $213.80 | $288.40 | $457.09 |
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 $112.20 Median $144.54 Typical High $158.49 | Professional | 52 · Reduced service | $112.20 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $57.54 Typical High $63.10 | Professional | 53 · Discontinued | $44.67 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $218.78 Typical High $234.42 | Professional | 54 · Surgery only | $169.82 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $43.65 Typical High $47.86 | Professional | 55 · Aftercare only | $33.88 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $22.39 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $204.17 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $158.49 | $204.17 | $218.78 |
Where Indiana sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 38th of 51
$275
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.