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 $245.47 Median $5,011.87 Typical High $14,125.38 | Facility | None | $245.47 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $245.47 Typical High $338.84 | Professional | None | $239.88 | $245.47 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $9,549.93 | Facility | None | $1,174.90 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $363.08 | Professional | None | $208.93 | $302.00 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $2,884.03 | Facility | None | $251.19 | $251.19 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,187.76 Typical High $3,311.31 | Facility | None | $776.25 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $478.63 | Professional | None | $234.42 | $302.00 | $478.63 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $676.08 Median $2,951.21 Typical High $4,677.35 | Facility | None | $676.08 | $2,951.21 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $457.09 | Professional | None | $257.04 | $346.74 | $457.09 |
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 $204.17 Median $257.04 Typical High $389.05 | Professional | None | $204.17 | $257.04 | $389.05 |
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 $120.23 Median $120.23 Typical High $158.49 | Professional | 52 · Reduced service | $120.23 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $48.98 Typical High $63.10 | Professional | 53 · Discontinued | $47.86 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $239.88 | Professional | 54 · Surgery only | $177.83 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $47.86 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $24.55 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.99 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $169.82 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $165.96 | $169.82 | $223.87 |
Where Indiana sits
The same service costs 6.0 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
$288
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.