How much rates vary
Facilitymedian $331 · 10th to 90th $45 to $955Professionalmedian $182 · 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 $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 $302.00 | Professional | None | $44.67 | $44.67 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $645.65 | Facility | None | $331.13 | $331.13 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $331.13 Typical High $371.54 | Professional | None | $100.00 | $331.13 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $26.92 Median $38.90 Typical High $114.82 | Facility | None | $26.92 | $38.90 | $114.82 |
CareSource Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | None | $33.88 | $33.88 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $302.00 | Professional | None | $112.20 | $165.96 | $302.00 |
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 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $70.79 | Professional | None | $39.81 | $52.48 | $70.79 |
5 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 $158.49 Median $257.04 Typical High $257.04 | Professional | AA · Anesthesiologist | $158.49 | $257.04 | $257.04 |
Ambetter Setting Professional Modifier QZ · CRNA, independent Typical Low $138.04 Median $138.04 Typical High $204.17 | Professional | QZ · CRNA, independent | $138.04 | $138.04 | $204.17 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P3 · Severe systemic disease Typical Low $109.65 Median $169.82 Typical High $223.87 | Professional | P3 · Severe systemic disease | $109.65 | $169.82 | $223.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $138.04 Median $223.87 Typical High $295.12 | Professional | P4 · Life-threatening disease | $138.04 | $223.87 | $295.12 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $181.97 Median $281.84 Typical High $371.54 | Professional | P5 · Not expected to survive without surgery | $181.97 | $281.84 | $371.54 |