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 $537.03 Median $5,011.87 Typical High $14,125.38 | Facility | None | $537.03 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $741.31 | Professional | None | $501.19 | $537.03 | $741.31 |
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 $81.28 Median $95.50 Typical High $151.36 | Professional | None | $81.28 | $95.50 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $12,302.69 Typical High $18,620.87 | Facility | None | $831.76 | $12,302.69 | $18,620.87 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,918.31 Typical High $11,220.18 | Facility | None | $645.65 | $6,918.31 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 |
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 $323.59 Median $501.19 Typical High $891.25 | Professional | None | $323.59 | $501.19 | $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 $251.19 Median $269.15 Typical High $371.54 | Professional | 52 · Reduced service | $251.19 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $147.91 | Professional | 53 · Discontinued | $100.00 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $562.34 | Professional | 54 · Surgery only | $371.54 | $398.11 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $112.20 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $74.13 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $74.13 |
Where Indiana sits
The same service costs 14.8 times more in Texas 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· 46th of 51
$537
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.