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 $288.40 Median $5,011.87 Typical High $9,772.37 | Facility | None | $288.40 | $5,011.87 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $407.38 | Professional | None | $269.15 | $288.40 | $407.38 |
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 $616.60 Median $758.58 Typical High $1,174.90 | Professional | None | $616.60 | $758.58 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $6,456.54 Typical High $9,772.37 | Facility | None | $436.52 | $6,456.54 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $19,498.45 Typical High $32,359.37 | Facility | None | $645.65 | $19,498.45 | $32,359.37 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $30,902.95 | Facility | None | $912.01 | $954.99 | $30,902.95 |
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 $549.54 Median $794.33 Typical High $1,174.90 | Professional | None | $549.54 | $794.33 | $1,174.90 |
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 $134.90 Median $144.54 Typical High $204.17 | Professional | 52 · Reduced service | $134.90 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $57.54 Typical High $81.28 | Professional | 53 · Discontinued | $53.70 | $57.54 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $213.80 Typical High $302.00 | Professional | 54 · Surgery only | $199.53 | $213.80 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $42.66 Typical High $60.26 | Professional | 55 · Aftercare only | $40.74 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.84 Typical High $40.74 | Professional | 56 · Pre-op care only | $26.92 | $28.84 | $40.74 |
Where Indiana sits
The same service costs 27.5 times more in Oklahoma 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
$1,000
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.