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 $223.87 Median $5,011.87 Typical High $14,125.38 | Facility | None | $223.87 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $331.13 | Professional | None | $208.93 | $223.87 | $331.13 |
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 $1,122.02 | Professional | None | $575.44 | $707.95 | $1,122.02 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $5,495.41 Typical High $8,317.64 | Facility | None | $363.08 | $5,495.41 | $8,317.64 |
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 $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $309.03 Median $467.74 Typical High $645.65 | Professional | None | $309.03 | $467.74 | $645.65 |
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 $104.71 Median $112.20 Typical High $165.96 | Professional | 52 · Reduced service | $104.71 | $112.20 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $66.07 | Professional | 53 · Discontinued | $41.69 | $44.67 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $169.82 Typical High $251.19 | Professional | 54 · Surgery only | $158.49 | $169.82 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.88 Typical High $50.12 | Professional | 55 · Aftercare only | $31.62 | $33.88 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $33.11 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $33.11 |
Where Indiana sits
The same service costs 15.8 times more in Arkansas than in Maine. 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· 22nd 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.