How much rates vary
Facilitymedian $1,479 · 10th to 90th $234 to $1,698Professionalmedian $794 · 10th to 90th $45 to $1,175
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 $1,513.56 Typical High $1,698.24 | Facility | None | $44.67 | $1,513.56 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $1,412.54 | Professional | None | $44.67 | $44.67 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $977.24 | Professional | None | $676.08 | $794.33 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $245.47 Typical High $741.31 | Facility | None | $234.42 | $245.47 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,621.81 | Professional | None | $660.69 | $977.24 | $1,621.81 |
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 $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
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 $691.83 Median $1,071.52 Typical High $1,412.54 | Professional | P3 · Severe systemic disease | $691.83 | $1,071.52 | $1,412.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $724.44 Median $1,122.02 Typical High $1,479.11 | Professional | P4 · Life-threatening disease | $724.44 | $1,122.02 | $1,479.11 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $758.58 Median $1,202.26 Typical High $1,548.82 | Professional | P5 · Not expected to survive without surgery | $758.58 | $1,202.26 | $1,548.82 |