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 $109.65 Median $1,380.38 Typical High $5,011.87 | Facility | None | $109.65 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $177.83 | Professional | None | $109.65 | $141.25 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $204.17 | Professional | None | $134.90 | $141.25 | $204.17 |
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 $186.21 | Professional | None | $89.13 | $144.54 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $616.60 Typical High $912.01 | Facility | None | $114.82 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $223.87 | Professional | None | $95.50 | $147.91 | $223.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $281.84 Median $398.11 Typical High $2,089.30 | Facility | None | $281.84 | $398.11 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $251.19 | Professional | None | $114.82 | $173.78 | $251.19 |
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 $102.33 Median $144.54 Typical High $234.42 | Professional | None | $102.33 | $144.54 | $234.42 |
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 $54.95 Median $70.79 Typical High $79.43 | Professional | 52 · Reduced service | $54.95 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.18 Typical High $31.62 | Professional | 53 · Discontinued | $21.88 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $107.15 Typical High $120.23 | Professional | 54 · Surgery only | $81.28 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.38 Typical High $23.99 | Professional | 55 · Aftercare only | $16.60 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.13 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.96 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $100.00 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $75.86 | $100.00 | $112.20 |
Where Indiana sits
The same service costs 4.1 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· 38th of 51
$148
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.