How much rates vary
Facilitymedian $871 · 10th to 90th $129 to $1,000Professionalmedian $457 · 10th to 90th $45 to $575
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 $870.96 Typical High $1,000.00 | Facility | None | $44.67 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $794.33 | Professional | None | $44.67 | $44.67 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $575.44 | Professional | None | $389.05 | $457.09 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $141.25 Typical High $426.58 | Facility | None | $128.82 | $141.25 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $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 $398.11 Median $616.60 Typical High $812.83 | Professional | P3 · Severe systemic disease | $398.11 | $616.60 | $812.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $436.52 Median $676.08 Typical High $891.25 | Professional | P4 · Life-threatening disease | $436.52 | $676.08 | $891.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $467.74 Median $741.31 Typical High $977.24 | Professional | P5 · Not expected to survive without surgery | $467.74 | $741.31 | $977.24 |