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 $269.15 Median $5,011.87 Typical High $14,125.38 | Facility | None | $269.15 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $398.11 | Professional | None | $251.19 | $269.15 | $398.11 |
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 $575.44 Median $707.95 Typical High $1,096.48 | Professional | None | $575.44 | $707.95 | $1,096.48 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $6,606.93 Typical High $9,772.37 | Facility | None | $436.52 | $6,606.93 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $10,000.00 Typical High $16,218.10 | Facility | None | $645.65 | $10,000.00 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,290.87 | Facility | None | $912.01 | $954.99 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $8,912.51 Typical High $16,218.10 | Facility | None | $1,621.81 | $8,912.51 | $16,218.10 |
United Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $691.83 | Professional | None | $295.12 | $457.09 | $691.83 |
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 $125.89 Median $134.90 Typical High $199.53 | Professional | 52 · Reduced service | $125.89 | $134.90 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $53.70 Typical High $79.43 | Professional | 53 · Discontinued | $50.12 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $199.53 Typical High $295.12 | Professional | 54 · Surgery only | $186.21 | $199.53 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $39.81 Typical High $58.88 | Professional | 55 · Aftercare only | $37.15 | $39.81 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.92 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.12 | $26.92 | $39.81 |
Where Indiana sits
The same service costs 16.2 times more in Arkansas than in West Virginia. 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· 23rd of 51
$912
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.