How much rates vary
Facilitymedian $479 · 10th to 90th $66 to $955Professionalmedian $251 · 10th to 90th $45 to $331
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 $478.63 Typical High $537.03 | Facility | None | $44.67 | $478.63 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $446.68 | Professional | None | $44.67 | $44.67 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $309.03 | Professional | None | $213.80 | $251.19 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $77.62 Typical High $229.09 | Facility | None | $66.07 | $77.62 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $446.68 | Professional | None | $186.21 | $269.15 | $446.68 |
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 $218.78 Median $338.84 Typical High $446.68 | Professional | P3 · Severe systemic disease | $218.78 | $338.84 | $446.68 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $251.19 Median $398.11 Typical High $524.81 | Professional | P4 · Life-threatening disease | $251.19 | $398.11 | $524.81 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $288.40 Median $457.09 Typical High $602.56 | Professional | P5 · Not expected to survive without surgery | $288.40 | $457.09 | $602.56 |