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 $891.25 Median $3,467.37 Typical High $5,011.87 | Facility | None | $891.25 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,318.26 | Professional | None | $831.76 | $891.25 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,513.56 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,230.27 | $1,905.46 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $21,877.62 Typical High $32,359.37 | Facility | None | $1,445.44 | $21,877.62 | $32,359.37 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,288.25 Typical High $16,595.87 | Facility | None | $524.81 | $1,288.25 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,862.09 | $2,754.23 |
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 $416.87 Median $446.68 Typical High $660.69 | Professional | 52 · Reduced service | $416.87 | $446.68 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $263.03 | Professional | 53 · Discontinued | $165.96 | $177.83 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $676.08 Typical High $977.24 | Professional | 54 · Surgery only | $630.96 | $676.08 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $134.90 Typical High $194.98 | Professional | 55 · Aftercare only | $125.89 | $134.90 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $131.83 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $131.83 |
Where Indiana sits
The same service costs 6.8 times more in Alaska than in Arkansas. 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· 37th of 51
$1,514
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.