How much rates vary
Facilitymedian $324 · 10th to 90th $45 to $955Professionalmedian $170 · 10th to 90th $45 to $219
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 $323.59 Typical High $363.08 | Facility | None | $44.67 | $323.59 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $295.12 | Professional | None | $44.67 | $44.67 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $208.93 | Professional | None | $141.25 | $169.82 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $39.81 Median $51.29 Typical High $154.88 | Facility | None | $39.81 | $51.29 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $269.15 | Professional | None | $112.20 | $162.18 | $269.15 |
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 $144.54 Median $229.09 Typical High $295.12 | Professional | P3 · Severe systemic disease | $144.54 | $229.09 | $295.12 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $181.97 Median $281.84 Typical High $371.54 | Professional | P4 · Life-threatening disease | $181.97 | $281.84 | $371.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $218.78 Median $338.84 Typical High $446.68 | Professional | P5 · Not expected to survive without surgery | $218.78 | $338.84 | $446.68 |