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 $93.33 Median $138.04 Typical High $5,011.87 | Facility | None | $93.33 | $138.04 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $151.36 | Professional | None | $93.33 | $125.89 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $173.78 | Professional | None | $75.86 | $120.23 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $190.55 | Facility | None | $97.72 | $97.72 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $177.83 Typical High $933.25 | Facility | None | $104.71 | $177.83 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $269.15 | Professional | None | $97.72 | $138.04 | $269.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $173.78 Median $275.42 Typical High $2,630.27 | Facility | None | $173.78 | $275.42 | $2,630.27 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $245.47 | Professional | None | $100.00 | $158.49 | $245.47 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $213.80 | Professional | None | $89.13 | $128.82 | $213.80 |
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 $46.77 Median $64.57 Typical High $75.86 | Professional | 52 · Reduced service | $46.77 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $25.70 Typical High $30.90 | Professional | 53 · Discontinued | $18.62 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $97.72 Typical High $114.82 | Professional | 54 · Surgery only | $70.79 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $19.50 Typical High $22.91 | Professional | 55 · Aftercare only | $14.13 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.33 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $91.20 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $66.07 | $91.20 | $107.15 |
Where Indiana sits
The same service costs 3.5 times more in Wisconsin 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· 43rd of 51
$135
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.