How much rates vary
Facilitymedian $437 · 10th to 90th $68 to $5,012Professionalmedian $68 · 10th to 90th $50 to $95
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $50.12 Median $3,467.37 Typical High $5,011.87 | Facility | None | $50.12 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None (both parts) Typical Low $43.65 Median $50.12 Typical High $69.18 | Professional | None (both parts) | $43.65 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $16.22 Median $19.95 Typical High $27.54 | Professional | 26 · Professional part | $16.22 | $19.95 | $27.54 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $27.54 Median $30.20 Typical High $41.69 | Professional | TC · Technical part | $27.54 | $30.20 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $114.82 Typical High $151.36 | Facility | None | $67.61 | $114.82 | $151.36 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $53.70 Median $67.61 Typical High $85.11 | Professional | None (both parts) | $53.70 | $67.61 | $85.11 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $20.42 Median $27.54 Typical High $45.71 | Professional | 26 · Professional part | $20.42 | $27.54 | $45.71 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $13.49 Median $15.85 Typical High $23.99 | Professional | TC · Technical part | $13.49 | $15.85 | $23.99 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $645.65 Typical High $1,621.81 | Facility | None | $72.44 | $645.65 | $1,621.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $117.49 Median $117.49 Typical High $354.81 | Professional | None (both parts) | $117.49 | $117.49 | $354.81 |
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 (both parts) Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None (both parts) | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None (both parts) Typical Low $64.57 Median $83.18 Typical High $147.91 | Professional | None (both parts) | $64.57 | $83.18 | $147.91 |
United Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $44.67 Typical High $79.43 | Professional | 26 · Professional part | $26.92 | $44.67 | $79.43 |
United Setting Professional Modifier TC · Technical part Typical Low $27.54 Median $44.67 Typical High $64.57 | Professional | TC · Technical part | $27.54 | $44.67 | $64.57 |
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 $21.88 Median $25.12 Typical High $34.67 | Professional | 52 · Reduced service | $21.88 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.00 Typical High $13.80 | Professional | 53 · Discontinued | $8.71 | $10.00 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $37.15 Typical High $52.48 | Professional | 54 · Surgery only | $33.11 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.59 Typical High $10.47 | Professional | 55 · Aftercare only | $6.61 | $7.59 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.01 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.37 | $5.01 | $6.92 |
Where Indiana sits
The same service costs 4.4 times more in Texas 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
$67.61
TX $174NY $39.81
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.