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 $199.53 Median $5,011.87 Typical High $5,623.41 | Facility | None | $199.53 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $323.59 | Professional | None | $186.21 | $199.53 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $758.58 | Professional | None | $426.58 | $501.19 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $4,897.79 Typical High $7,244.36 | Facility | None | $323.59 | $4,897.79 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $1,412.54 | Facility | None | $489.78 | $691.83 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | None | $562.34 | $660.69 | $660.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $870.96 Median $954.99 Typical High $2,187.76 | Facility | None | $870.96 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $204.17 | Professional | None | $173.78 | $173.78 | $204.17 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $501.19 | Professional | None | $162.18 | $302.00 | $501.19 |
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 $91.20 Median $97.72 Typical High $138.04 | Professional | 52 · Reduced service | $91.20 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $39.81 Typical High $54.95 | Professional | 53 · Discontinued | $37.15 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $147.91 Typical High $208.93 | Professional | 54 · Surgery only | $138.04 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $29.51 Typical High $41.69 | Professional | 55 · Aftercare only | $27.54 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.95 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.62 | $19.95 | $27.54 |
Where Indiana sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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
$501
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.