How much rates vary
Facilitymedian $646 · 10th to 90th $91 to $955Professionalmedian $339 · 10th to 90th $45 to $447
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 $645.65 Typical High $724.44 | Facility | None | $44.67 | $645.65 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $588.84 | Professional | None | $44.67 | $44.67 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $416.87 | Professional | None | $288.40 | $338.84 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $91.20 Median $102.33 Typical High $309.03 | Facility | None | $91.20 | $102.33 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $630.96 | Professional | None | $257.04 | $380.19 | $630.96 |
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 |
3 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 |
|---|---|---|---|---|---|
Physicians Health Plan of Northern Indiana Setting Professional Modifier P3 · Severe systemic disease Typical Low $288.40 Median $457.09 Typical High $602.56 | Professional | P3 · Severe systemic disease | $288.40 | $457.09 | $602.56 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $323.59 Median $512.86 Typical High $676.08 | Professional | P4 · Life-threatening disease | $323.59 | $512.86 | $676.08 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $363.08 Median $575.44 Typical High $741.31 | Professional | P5 · Not expected to survive without surgery | $363.08 | $575.44 | $741.31 |