How much rates vary
Facilitymedian $1,380 · 10th to 90th $219 to $1,622Professionalmedian $759 · 10th to 90th $45 to $1,023
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 $1,445.44 Typical High $1,621.81 | Facility | None | $44.67 | $1,445.44 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $1,318.26 | Professional | None | $44.67 | $44.67 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $933.25 | Professional | None | $645.65 | $758.58 | $933.25 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $229.09 Typical High $691.83 | Facility | None | $218.78 | $229.09 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,513.56 | Professional | None | $630.96 | $912.01 | $1,513.56 |
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 $645.65 Median $1,023.29 Typical High $1,348.96 | Professional | P3 · Severe systemic disease | $645.65 | $1,023.29 | $1,348.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $691.83 Median $1,071.52 Typical High $1,412.54 | Professional | P4 · Life-threatening disease | $691.83 | $1,071.52 | $1,412.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $724.44 Median $1,148.15 Typical High $1,479.11 | Professional | P5 · Not expected to survive without surgery | $724.44 | $1,148.15 | $1,479.11 |