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 $346.74 Median $5,011.87 Typical High $14,125.38 | Facility | None | $346.74 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $489.78 | Professional | None | $323.59 | $346.74 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $38,904.51 Typical High $77,624.71 | Facility | None | $2,570.40 | $38,904.51 | $77,624.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $977.24 | Professional | None | $501.19 | $630.96 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $478.63 Median $7,079.46 Typical High $10,715.19 | Facility | None | $478.63 | $7,079.46 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $10,471.29 Typical High $16,982.44 | Facility | None | $645.65 | $10,471.29 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $1,548.82 Median $14,454.40 Typical High $29,512.09 | Facility | None | $1,548.82 | $14,454.40 | $29,512.09 |
United Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,000.00 | Professional | None | $478.63 | $691.83 | $1,000.00 |
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 $162.18 Median $173.78 Typical High $239.88 | Professional | 52 · Reduced service | $162.18 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $69.18 Typical High $95.50 | Professional | 53 · Discontinued | $64.57 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $257.04 Typical High $363.08 | Professional | 54 · Surgery only | $239.88 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $52.48 Typical High $72.44 | Professional | 55 · Aftercare only | $48.98 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $47.86 |
Where Indiana sits
The same service costs 24.0 times more in Arkansas than in New York. 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· 40th of 51
$851
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.