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 $234.42 Median $5,011.87 Typical High $7,244.36 | Facility | None | $234.42 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $331.13 | Professional | None | $218.78 | $234.42 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $707.95 | Professional | None | $363.08 | $501.19 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $5,248.07 Typical High $7,943.28 | Facility | None | $354.81 | $5,248.07 | $7,943.28 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $3,388.44 | Facility | None | $645.65 | $1,778.28 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,398.83 | Facility | None | $912.01 | $954.99 | $2,398.83 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $851.14 | Professional | None | $398.11 | $588.84 | $851.14 |
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 $109.65 Median $117.49 Typical High $165.96 | Professional | 52 · Reduced service | $109.65 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $46.77 Typical High $66.07 | Professional | 53 · Discontinued | $43.65 | $46.77 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $173.78 Typical High $245.47 | Professional | 54 · Surgery only | $162.18 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $34.67 Typical High $48.98 | Professional | 55 · Aftercare only | $32.36 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.44 Typical High $33.11 | Professional | 56 · Pre-op care only | $21.88 | $23.44 | $33.11 |
Where Indiana sits
The same service costs 8.1 times more in Texas than in New York. 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· 38th of 51
$646
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.