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 $173.78 Median $5,011.87 Typical High $5,623.41 | Facility | None | $173.78 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $257.04 | Professional | None | $162.18 | $173.78 | $257.04 |
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 $147.91 Median $173.78 Typical High $263.03 | Professional | None | $147.91 | $173.78 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $281.84 Median $4,168.69 Typical High $6,309.57 | Facility | None | $281.84 | $4,168.69 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $1,659.59 | Facility | None | $524.81 | $724.44 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $109.65 Median $173.78 Typical High $407.38 | Professional | None | $109.65 | $173.78 | $407.38 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $549.54 | Professional | None | $257.04 | $331.13 | $549.54 |
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 $81.28 Median $87.10 Typical High $125.89 | Professional | 52 · Reduced service | $81.28 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $34.67 Typical High $51.29 | Professional | 53 · Discontinued | $33.11 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $131.83 Typical High $190.55 | Professional | 54 · Surgery only | $123.03 | $131.83 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $26.30 Typical High $38.02 | Professional | 55 · Aftercare only | $24.55 | $26.30 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.22 | $17.38 | $25.70 |
Where Indiana sits
The same service costs 8.3 times more in Alaska 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· 47th of 51
$234
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.