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 $1,380.38 Typical High $11,220.18 | Facility | None | $208.93 | $1,380.38 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $331.13 | Professional | None | $208.93 | $251.19 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $891.25 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $331.13 | Professional | None | $162.18 | $234.42 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $2,041.74 | Facility | None | $213.80 | $213.80 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,737.80 Typical High $2,691.53 | Facility | None | $630.96 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $389.05 | Professional | None | $204.17 | $257.04 | $389.05 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $575.44 Median $2,089.30 Typical High $3,388.44 | Facility | None | $575.44 | $2,089.30 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $478.63 | Professional | None | $218.78 | $323.59 | $478.63 |
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 $190.55 Median $257.04 Typical High $416.87 | Professional | None | $190.55 | $257.04 | $416.87 |
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 $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $104.71 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $41.69 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $204.17 | Professional | 54 · Surgery only | $158.49 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.89 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $169.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $147.91 | $169.82 | $190.55 |
Where Indiana sits
The same service costs 4.7 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· 42nd of 51
$275
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.