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 $158.49 Median $5,011.87 Typical High $14,125.38 | Facility | None | $158.49 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $223.87 | Professional | None | $147.91 | $158.49 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $4,786.30 Typical High $16,218.10 | Facility | None | $1,862.09 | $4,786.30 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $524.81 | Professional | None | $275.42 | $338.84 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $3,715.35 Typical High $5,623.41 | Facility | None | $251.19 | $3,715.35 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $4,570.88 | Facility | None | $645.65 | $2,754.23 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
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 $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $4,168.69 Typical High $9,120.11 | Facility | None | $1,096.48 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $457.09 | Professional | None | $218.78 | $323.59 | $457.09 |
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 $74.13 Median $79.43 Typical High $112.20 | Professional | 52 · Reduced service | $74.13 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $31.62 Typical High $45.71 | Professional | 53 · Discontinued | $29.51 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $117.49 Typical High $169.82 | Professional | 54 · Surgery only | $109.65 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $23.44 Typical High $33.88 | Professional | 55 · Aftercare only | $21.88 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.85 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.79 | $15.85 | $22.39 |
Where Indiana sits
The same service costs 10.7 times more in Colorado 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· 23rd of 51
$661
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.