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 $524.81 Median $5,011.87 Typical High $11,220.18 | Facility | None | $524.81 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $758.58 | Professional | None | $489.78 | $524.81 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $11,481.54 Typical High $23,442.29 | Facility | None | $1,445.44 | $11,481.54 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,202.26 | Professional | None | $691.83 | $812.83 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $12,022.64 Typical High $17,782.79 | Facility | None | $794.33 | $12,022.64 | $17,782.79 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,370.32 Typical High $8,709.64 | Facility | None | $645.65 | $5,370.32 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,248.07 Typical High $10,000.00 | Facility | None | $912.01 | $5,248.07 | $10,000.00 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $891.25 | Professional | None | $467.74 | $537.03 | $891.25 |
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 $602.56 Median $831.76 Typical High $1,318.26 | Professional | None | $602.56 | $831.76 | $1,318.26 |
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 $245.47 Median $263.03 Typical High $371.54 | Professional | 52 · Reduced service | $245.47 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $147.91 | Professional | 53 · Discontinued | $100.00 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $549.54 | Professional | 54 · Surgery only | $371.54 | $398.11 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $109.65 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $74.13 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $74.13 |
Where Indiana sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 36th of 51
$891
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.