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 $208.93 Median $275.42 Typical High $11,481.54 | Facility | None | $208.93 | $275.42 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $208.93 Typical High $295.12 | Professional | None | $204.17 | $208.93 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $218.78 | Professional | None | $83.18 | $91.20 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $5,248.07 Typical High $9,549.93 | Facility | None | $1,230.27 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $323.59 | Professional | None | $181.97 | $288.40 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $2,884.03 | Facility | None | $218.78 | $218.78 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,290.87 Typical High $3,311.31 | Facility | None | $741.31 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $426.58 | Professional | None | $199.53 | $239.88 | $426.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $588.84 Median $2,951.21 Typical High $6,025.60 | Facility | None | $588.84 | $2,951.21 | $6,025.60 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $371.54 | Professional | None | $223.87 | $295.12 | $371.54 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $331.13 | Professional | None | $177.83 | $218.78 | $331.13 |
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 $102.33 Median $104.71 Typical High $138.04 | Professional | 52 · Reduced service | $102.33 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $54.95 | Professional | 53 · Discontinued | $41.69 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $158.49 Typical High $204.17 | Professional | 54 · Surgery only | $154.88 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $40.74 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.89 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.42 | $20.89 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $147.91 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $144.54 | $147.91 | $190.55 |
Where Indiana sits
The same service costs 5.6 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· 32nd of 51
$245
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.