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 $114.82 Median $1,380.38 Typical High $5,623.41 | Facility | None | $114.82 | $1,380.38 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $223.87 | Professional | None | $109.65 | $158.49 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $162.18 | Professional | None | $93.33 | $114.82 | $162.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $169.82 Typical High $251.19 | Professional | 50 · Both sides | $138.04 | $169.82 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $257.04 | Facility | None | $125.89 | $125.89 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $208.93 Typical High $354.81 | Facility | None | $66.07 | $208.93 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $295.12 | Professional | None | $112.20 | $169.82 | $295.12 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $346.74 Typical High $2,089.30 | Facility | None | $229.09 | $346.74 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $316.23 | Professional | None | $131.83 | $204.17 | $316.23 |
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 $114.82 Median $177.83 Typical High $309.03 | Professional | None | $114.82 | $177.83 | $309.03 |
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 $54.95 Median $75.86 Typical High $85.11 | Professional | 52 · Reduced service | $54.95 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.20 Typical High $33.88 | Professional | 53 · Discontinued | $22.39 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $114.82 Typical High $128.82 | Professional | 54 · Surgery only | $83.18 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.91 Typical High $25.70 | Professional | 55 · Aftercare only | $16.60 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.14 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.96 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $107.15 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $77.62 | $107.15 | $120.23 |
Where Indiana sits
The same service costs 4.1 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· 47th of 51
$166
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.