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 $223.87 Median $5,011.87 Typical High $11,220.18 | Facility | None | $223.87 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $316.23 | Professional | None | $208.93 | $223.87 | $316.23 |
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 $123.03 Median $144.54 Typical High $223.87 | Professional | None | $123.03 | $144.54 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $5,128.61 Typical High $7,585.78 | Facility | None | $338.84 | $5,128.61 | $7,585.78 |
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 $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $5,128.61 | Facility | None | $912.01 | $2,290.87 | $5,128.61 |
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 $457.09 Median $741.31 Typical High $1,122.02 | Professional | None | $457.09 | $741.31 | $1,122.02 |
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 $104.71 Median $112.20 Typical High $158.49 | Professional | 52 · Reduced service | $104.71 | $112.20 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $63.10 | Professional | 53 · Discontinued | $41.69 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $169.82 Typical High $234.42 | Professional | 54 · Surgery only | $158.49 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.88 Typical High $47.86 | Professional | 55 · Aftercare only | $31.62 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $31.62 |
Where Indiana sits
The same service costs 10.2 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· 39th of 51
$871
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.