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 $323.59 Median $5,011.87 Typical High $11,220.18 | Facility | None | $323.59 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $467.74 | Professional | None | $302.00 | $323.59 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $16,218.10 Typical High $33,884.42 | Facility | None | $2,630.27 | $16,218.10 | $33,884.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,479.11 | Professional | None | $851.14 | $1,071.52 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $7,762.47 Typical High $11,481.54 | Facility | None | $512.86 | $7,762.47 | $11,481.54 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,606.93 Typical High $10,715.19 | Facility | None | $645.65 | $6,606.93 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,412.54 | $2,454.71 | $2,454.71 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $10,715.19 | Facility | None | $912.01 | $954.99 | $10,715.19 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $245.47 Median $446.68 Typical High $724.44 | Professional | None | $245.47 | $446.68 | $724.44 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $891.25 | Professional | None | $380.19 | $537.03 | $891.25 |
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 $151.36 Median $162.18 Typical High $234.42 | Professional | 52 · Reduced service | $151.36 | $162.18 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $64.57 Typical High $93.33 | Professional | 53 · Discontinued | $60.26 | $64.57 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $346.74 | Professional | 54 · Surgery only | $223.87 | $239.88 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $69.18 | Professional | 55 · Aftercare only | $44.67 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $32.36 Typical High $46.77 | Professional | 56 · Pre-op care only | $30.20 | $32.36 | $46.77 |
Where Indiana sits
The same service costs 7.2 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· 7th of 51
$1,072
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.