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 $147.91 Median $1,380.38 Typical High $7,244.36 | Facility | None | $147.91 | $1,380.38 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $316.23 | Professional | None | $147.91 | $263.03 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $338.84 | Professional | None | $125.89 | $125.89 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $229.09 | Professional | None | $125.89 | $151.36 | $229.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $229.09 Typical High $338.84 | Professional | 50 · Both sides | $190.55 | $229.09 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $398.11 | Facility | None | $154.88 | $154.88 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $389.05 Typical High $794.33 | Facility | None | $245.47 | $389.05 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $501.19 | Professional | None | $123.03 | $208.93 | $501.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $316.23 Median $501.19 Typical High $1,778.28 | Facility | None | $316.23 | $501.19 | $1,778.28 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $501.19 | Professional | None | $177.83 | $323.59 | $501.19 |
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 $151.36 Median $263.03 Typical High $446.68 | Professional | None | $151.36 | $263.03 | $446.68 |
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 $74.13 Median $131.83 Typical High $154.88 | Professional | 52 · Reduced service | $74.13 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $52.48 Typical High $63.10 | Professional | 53 · Discontinued | $29.51 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $109.65 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $39.81 Typical High $46.77 | Professional | 55 · Aftercare only | $21.88 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $26.30 Typical High $31.62 | Professional | 56 · Pre-op care only | $14.79 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $181.97 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $102.33 | $181.97 | $218.78 |
Where Indiana sits
The same service costs 3.8 times more in Wyoming 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
$251
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.