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 $331.13 Median $2,570.40 Typical High $16,595.87 | Facility | None | $331.13 | $2,570.40 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $446.68 | Professional | None | $323.59 | $380.19 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $9,549.93 | Facility | None | $1,380.38 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $588.84 | Professional | None | $309.03 | $436.52 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $3,467.37 | Facility | None | $380.19 | $380.19 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,570.40 Typical High $3,801.89 | Facility | None | $812.83 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $630.96 | Professional | None | $338.84 | $426.58 | $630.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $4,570.88 | Facility | None | $933.25 | $2,951.21 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $724.44 | Professional | None | $380.19 | $489.78 | $724.44 |
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 $331.13 Median $436.52 Typical High $676.08 | Professional | None | $331.13 | $436.52 | $676.08 |
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 $162.18 Median $190.55 Typical High $223.87 | Professional | 52 · Reduced service | $162.18 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $64.57 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $288.40 Typical High $338.84 | Professional | 54 · Surgery only | $239.88 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $57.54 Typical High $67.61 | Professional | 55 · Aftercare only | $47.86 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $38.02 Typical High $44.67 | Professional | 56 · Pre-op care only | $32.36 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $269.15 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $223.87 | $269.15 | $316.23 |
Where Indiana sits
The same service costs 4.3 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· 44th of 51
$437
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.