How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $933.25 Median $5,011.87 Typical High $7,244.36 | Facility | None | $933.25 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,380.38 | Professional | None | $912.01 | $977.24 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $38,904.51 Typical High $77,624.71 | Facility | None | $2,570.40 | $38,904.51 | $77,624.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,258.93 | Professional | None | $537.03 | $630.96 | $1,258.93 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $21,877.62 Typical High $33,113.11 | Facility | None | $1,445.44 | $21,877.62 | $33,113.11 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $15,848.93 Typical High $26,302.68 | Facility | None | $851.14 | $15,848.93 | $26,302.68 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $26,302.68 | Facility | None | $912.01 | $954.99 | $26,302.68 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $12,302.69 Typical High $43,651.58 | Facility | None | $2,238.72 | $12,302.69 | $43,651.58 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,096.48 | $1,621.81 | $2,630.27 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $489.78 Typical High $676.08 | Professional | 52 · Reduced service | $457.09 | $489.78 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $275.42 | Professional | 53 · Discontinued | $181.97 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $1,023.29 | Professional | 54 · Surgery only | $691.83 | $741.31 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $204.17 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $138.04 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $138.04 |
Where Indiana sits
The same service costs 6.9 times more in Arkansas than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 26th of 51
$1,995
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.