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 $138.04 Median $5,011.87 Typical High $5,623.41 | Facility | None | $138.04 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $229.09 | Professional | None | $128.82 | $138.04 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,584.89 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $186.21 | Professional | None | $107.15 | $125.89 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $3,801.89 Typical High $5,754.40 | Facility | None | $251.19 | $3,801.89 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,162.28 | Facility | None | $645.65 | $2,238.72 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $3,162.28 | Facility | None | $912.01 | $954.99 | $3,162.28 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $229.09 | Professional | None | $104.71 | $141.25 | $229.09 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,230.27 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $316.23 | Professional | None | $141.25 | $229.09 | $316.23 |
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 $64.57 Median $69.18 Typical High $114.82 | Professional | 52 · Reduced service | $64.57 | $69.18 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $27.54 Typical High $45.71 | Professional | 53 · Discontinued | $25.70 | $27.54 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $102.33 Typical High $173.78 | Professional | 54 · Surgery only | $95.50 | $102.33 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.42 Typical High $34.67 | Professional | 55 · Aftercare only | $19.05 | $20.42 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.80 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.88 | $13.80 | $22.91 |
Where Indiana sits
The same service costs 19.5 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· 49th of 51
$186
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.