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 $213.80 Median $3,467.37 Typical High $5,011.87 | Facility | None | $213.80 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $302.00 | Professional | None | $199.53 | $213.80 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,288.25 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $467.74 | Professional | None | $269.15 | $316.23 | $467.74 |
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 $512.86 Median $1,318.26 Typical High $27,542.29 | Facility | None | $512.86 | $1,318.26 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
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 |
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 $302.00 Median $398.11 Typical High $575.44 | Professional | None | $302.00 | $398.11 | $575.44 |
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 $100.00 Median $107.15 Typical High $147.91 | Professional | 52 · Reduced service | $100.00 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $42.66 Typical High $60.26 | Professional | 53 · Discontinued | $39.81 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $162.18 Typical High $223.87 | Professional | 54 · Surgery only | $151.36 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $32.36 Typical High $44.67 | Professional | 55 · Aftercare only | $30.20 | $32.36 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.95 | $21.38 | $29.51 |
Where Indiana sits
The same service costs 6.3 times more in Texas than in Pennsylvania. 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· 43rd of 51
$363
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.