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 $204.17 Median $295.12 Typical High $5,011.87 | Facility | None | $204.17 | $295.12 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $281.84 | Professional | None | $181.97 | $213.80 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $338.84 | Professional | None | $169.82 | $223.87 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $3,467.37 | Facility | None | $186.21 | $186.21 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $2,238.72 Typical High $3,801.89 | Facility | None | $407.38 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $371.54 | Professional | None | $190.55 | $239.88 | $371.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $501.19 Median $2,951.21 Typical High $4,570.88 | Facility | None | $501.19 | $2,951.21 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $416.87 | Professional | None | $190.55 | $281.84 | $416.87 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $363.08 | Professional | None | $169.82 | $218.78 | $363.08 |
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 $91.20 Median $107.15 Typical High $123.03 | Professional | 52 · Reduced service | $91.20 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $42.66 Typical High $48.98 | Professional | 53 · Discontinued | $36.31 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $138.04 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $147.91 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $128.82 | $147.91 | $169.82 |
Where Indiana sits
The same service costs 4.4 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· 42nd of 51
$245
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.