How much rates vary
Facilitymedian $724 · 10th to 90th $105 to $955Professionalmedian $380 · 10th to 90th $45 to $513
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 $724.44 Typical High $812.83 | Facility | None | $44.67 | $724.44 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $660.69 | Professional | None | $44.67 | $44.67 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $467.74 | Professional | None | $323.59 | $380.19 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $114.82 Typical High $346.74 | Facility | None | $104.71 | $114.82 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $724.44 | Professional | None | $295.12 | $436.52 | $724.44 |
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 |
4 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier AA · Anesthesiologist Typical Low $741.31 Median $741.31 Typical High $1,445.44 | Professional | AA · Anesthesiologist | $741.31 | $741.31 | $1,445.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P3 · Severe systemic disease Typical Low $323.59 Median $512.86 Typical High $676.08 | Professional | P3 · Severe systemic disease | $323.59 | $512.86 | $676.08 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $363.08 Median $575.44 Typical High $741.31 | Professional | P4 · Life-threatening disease | $363.08 | $575.44 | $741.31 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $398.11 Median $616.60 Typical High $812.83 | Professional | P5 · Not expected to survive without surgery | $398.11 | $616.60 | $812.83 |