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 $134.90 Median $3,801.89 Typical High $5,623.41 | Facility | None | $134.90 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $257.04 | Professional | None | $134.90 | $223.87 | $257.04 |
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 $109.65 Median $181.97 Typical High $331.13 | Professional | None | $109.65 | $181.97 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $346.74 | Facility | None | $141.25 | $141.25 | $346.74 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $346.74 Typical High $724.44 | Facility | None | $173.78 | $346.74 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $380.19 | Professional | None | $128.82 | $229.09 | $380.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $309.03 Median $501.19 Typical High $1,288.25 | Facility | None | $309.03 | $501.19 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $407.38 | Professional | None | $162.18 | $275.42 | $407.38 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $323.59 | Professional | None | $128.82 | $199.53 | $323.59 |
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 $67.61 Median $112.20 Typical High $120.23 | Professional | 52 · Reduced service | $67.61 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $44.67 Typical High $47.86 | Professional | 53 · Discontinued | $26.92 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $165.96 Typical High $181.97 | Professional | 54 · Surgery only | $102.33 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $20.42 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $22.39 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.49 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $154.88 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $95.50 | $154.88 | $169.82 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 36th of 51
$214
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.