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 $181.97 Median $1,380.38 Typical High $5,011.87 | Facility | None | $181.97 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $323.59 | Professional | None | $181.97 | $257.04 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $269.15 | Professional | None | $89.13 | $144.54 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $489.78 | Facility | None | $181.97 | $181.97 | $489.78 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $575.44 Typical High $1,479.11 | Facility | None | $354.81 | $575.44 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $467.74 | Professional | None | $123.03 | $218.78 | $467.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $457.09 Median $691.83 Typical High $2,089.30 | Facility | None | $457.09 | $691.83 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $524.81 | Professional | None | $223.87 | $346.74 | $524.81 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $380.19 | Professional | None | $128.82 | $208.93 | $380.19 |
7 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 $91.20 Median $131.83 Typical High $158.49 | Professional | 52 · Reduced service | $91.20 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $52.48 Typical High $63.10 | Professional | 53 · Discontinued | $36.31 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $199.53 Typical High $234.42 | Professional | 54 · Surgery only | $134.90 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $39.81 Typical High $46.77 | Professional | 55 · Aftercare only | $26.92 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.30 Typical High $31.62 | Professional | 56 · Pre-op care only | $18.20 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $186.21 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $125.89 | $186.21 | $218.78 |
Ambetter Setting Professional Modifier 51 · Multiple procedures + 59 · Distinct service Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 51 · Multiple procedures + 59 · Distinct service | $186.21 | $186.21 | $186.21 |
Where Indiana sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 50th of 51
$182
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.