How much rates vary
Facilitymedian $1,072 · 10th to 90th $170 to $1,259Professionalmedian $589 · 10th to 90th $45 to $794
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 $1,122.02 Typical High $1,258.93 | Facility | None | $44.67 | $1,122.02 | $1,258.93 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $1,047.13 | Professional | None | $44.67 | $44.67 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $724.44 | Professional | None | $501.19 | $588.84 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $181.97 Typical High $537.03 | Facility | None | $169.82 | $181.97 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,174.90 | Professional | None | $478.63 | $707.95 | $1,174.90 |
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 $512.86 Median $794.33 Typical High $1,047.13 | Professional | P3 · Severe systemic disease | $512.86 | $794.33 | $1,047.13 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $549.54 Median $851.14 Typical High $1,122.02 | Professional | P4 · Life-threatening disease | $549.54 | $851.14 | $1,122.02 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $575.44 Median $912.01 Typical High $1,202.26 | Professional | P5 · Not expected to survive without surgery | $575.44 | $912.01 | $1,202.26 |