How much rates vary
Facilitymedian $933 · 10th to 90th $141 to $1,072Professionalmedian $501 · 10th to 90th $45 to $676
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 $954.99 Typical High $1,071.52 | Facility | None | $44.67 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $870.96 | Professional | None | $44.67 | $44.67 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $9.55 | Professional | 53 · Discontinued | $8.91 | $8.91 | $9.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $630.96 | Professional | None | $426.58 | $501.19 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $154.88 Typical High $467.74 | Facility | None | $141.25 | $154.88 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $1,000.00 | Professional | None | $407.38 | $588.84 | $1,000.00 |
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 $436.52 Median $676.08 Typical High $891.25 | Professional | P3 · Severe systemic disease | $436.52 | $676.08 | $891.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $467.74 Median $741.31 Typical High $977.24 | Professional | P4 · Life-threatening disease | $467.74 | $741.31 | $977.24 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $512.86 Median $794.33 Typical High $1,047.13 | Professional | P5 · Not expected to survive without surgery | $512.86 | $794.33 | $1,047.13 |