How much rates vary
Facilitymedian $562 · 10th to 90th $78 to $955Professionalmedian $295 · 10th to 90th $45 to $363
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $44.67 Median $562.34 Typical High $630.96 | Facility | None | $44.67 | $562.34 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $512.86 | Professional | None | $44.67 | $44.67 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $363.08 | Professional | None | $251.19 | $295.12 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $89.13 Typical High $269.15 | Facility | None | $77.62 | $89.13 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,290.87 | Facility | None | $912.01 | $954.99 | $2,290.87 |
United Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $70.79 | Professional | None | $39.81 | $52.48 | $70.79 |
4 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier AA · Anesthesiologist Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | AA · Anesthesiologist | $138.04 | $138.04 | $138.04 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P3 · Severe systemic disease Typical Low $251.19 Median $398.11 Typical High $524.81 | Professional | P3 · Severe systemic disease | $251.19 | $398.11 | $524.81 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $288.40 Median $457.09 Typical High $602.56 | Professional | P4 · Life-threatening disease | $288.40 | $457.09 | $602.56 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $323.59 Median $512.86 Typical High $676.08 | Professional | P5 · Not expected to survive without surgery | $323.59 | $512.86 | $676.08 |