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 $177.83 Median $3,467.37 Typical High $7,244.36 | Facility | None | $177.83 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $251.19 | Professional | None | $177.83 | $218.78 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $3,235.94 Typical High $6,165.95 | Facility | None | $630.96 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $288.40 | Professional | None | $169.82 | $213.80 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $1,000.00 | Facility | None | $194.98 | $194.98 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $630.96 Typical High $1,258.93 | Facility | None | $257.04 | $630.96 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $489.78 | Professional | None | $177.83 | $263.03 | $489.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $512.86 Median $1,047.13 Typical High $2,187.76 | Facility | None | $512.86 | $1,047.13 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $446.68 | Professional | None | $204.17 | $316.23 | $446.68 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $389.05 | Professional | None | $165.96 | $223.87 | $389.05 |
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 $89.13 Median $109.65 Typical High $125.89 | Professional | 52 · Reduced service | $89.13 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $44.67 Typical High $50.12 | Professional | 53 · Discontinued | $35.48 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $165.96 Typical High $190.55 | Professional | 54 · Surgery only | $131.83 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $33.11 Typical High $38.02 | Professional | 55 · Aftercare only | $26.92 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $17.78 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $154.88 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $123.03 | $154.88 | $177.83 |
Where Indiana sits
The same service costs 4.3 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· 46th of 51
$224
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.