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 $257.04 Median $5,011.87 Typical High $11,220.18 | Facility | None | $257.04 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $389.05 | Professional | None | $239.88 | $257.04 | $389.05 |
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 $1,023.29 Median $1,202.26 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,202.26 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $5,128.61 Typical High $7,585.78 | Facility | None | $338.84 | $5,128.61 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $2,691.53 | Facility | None | $524.81 | $724.44 | $2,691.53 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | None | $537.03 | $537.03 | $630.96 |
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 $288.40 Median $602.56 Typical High $1,096.48 | Professional | None | $288.40 | $602.56 | $1,096.48 |
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 $120.23 Median $128.82 Typical High $177.83 | Professional | 52 · Reduced service | $120.23 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $51.29 Typical High $72.44 | Professional | 53 · Discontinued | $47.86 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $194.98 Typical High $269.15 | Professional | 54 · Surgery only | $181.97 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.90 Typical High $53.70 | Professional | 55 · Aftercare only | $36.31 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $35.48 | Professional | 56 · Pre-op care only | $23.99 | $25.70 | $35.48 |
Where Indiana sits
The same service costs 7.8 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· 10th of 51
$1,202
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.