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 $3,467.37 Typical High $5,623.41 | Facility | None | $208.93 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $346.74 | Professional | None | $208.93 | $213.80 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $3,801.89 Typical High $15,135.61 | Facility | None | $1,258.93 | $3,801.89 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $501.19 Typical High $549.54 | Professional | None | $181.97 | $501.19 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $3,311.31 | Facility | None | $223.87 | $223.87 | $3,311.31 |
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 $446.68 Median $2,089.30 Typical High $3,548.13 | Facility | None | $446.68 | $2,089.30 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $416.87 Typical High $724.44 | Professional | None | $223.87 | $416.87 | $724.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $575.44 Median $3,388.44 Typical High $5,011.87 | Facility | None | $575.44 | $3,388.44 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $436.52 | Professional | None | $223.87 | $302.00 | $436.52 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $549.54 | Professional | None | $199.53 | $354.81 | $549.54 |
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 $104.71 Median $107.15 Typical High $147.91 | Professional | 52 · Reduced service | $104.71 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $58.88 | Professional | 53 · Discontinued | $42.66 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $162.18 Typical High $223.87 | Professional | 54 · Surgery only | $158.49 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $32.36 Typical High $44.67 | Professional | 55 · Aftercare only | $31.62 | $32.36 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.38 Typical High $29.51 | Professional | 56 · Pre-op care only | $20.89 | $21.38 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $151.36 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $147.91 | $151.36 | $208.93 |
Where Indiana sits
The same service costs 4.6 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· 14th of 51
$427
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.