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 $239.88 Median $5,011.87 Typical High $14,125.38 | Facility | None | $239.88 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $346.74 | Professional | None | $223.87 | $239.88 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,513.56 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $776.25 | Professional | None | $398.11 | $549.54 | $776.25 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $5,754.40 Typical High $8,511.38 | Facility | None | $380.19 | $5,754.40 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $9,332.54 Typical High $15,488.17 | Facility | None | $645.65 | $9,332.54 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $15,488.17 | Facility | None | $912.01 | $954.99 | $15,488.17 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $8,912.51 Typical High $16,218.10 | Facility | None | $1,621.81 | $8,912.51 | $16,218.10 |
United Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $416.87 | Professional | None | $46.77 | $72.44 | $416.87 |
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 $112.20 Median $120.23 Typical High $173.78 | Professional | 52 · Reduced service | $112.20 | $120.23 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $47.86 Typical High $69.18 | Professional | 53 · Discontinued | $44.67 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $177.83 Typical High $257.04 | Professional | 54 · Surgery only | $165.96 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $33.88 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.99 Typical High $34.67 | Professional | 56 · Pre-op care only | $22.39 | $23.99 | $34.67 |
Where Indiana sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 31st of 51
$661
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.