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 $85.11 Median $5,011.87 Typical High $5,623.41 | Facility | None | $85.11 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $331.13 | Professional | None | $79.43 | $85.11 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $6,165.95 | Facility | None | $616.60 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $257.04 Typical High $1,862.09 | Professional | None | $107.15 | $257.04 | $1,862.09 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $5,495.41 Typical High $8,128.31 | Facility | None | $363.08 | $5,495.41 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $588.84 Typical High $1,479.11 | Facility | None | $371.54 | $588.84 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $4,570.88 | Professional | None | $338.84 | $338.84 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $338.84 Median $954.99 Typical High $2,290.87 | Facility | None | $338.84 | $954.99 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $128.82 Median $851.14 Typical High $3,630.78 | Professional | None | $128.82 | $851.14 | $3,630.78 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $245.47 | Professional | None | $60.26 | $117.49 | $245.47 |
4 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 $39.81 Median $42.66 Typical High $165.96 | Professional | 52 · Reduced service | $39.81 | $42.66 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.98 Typical High $66.07 | Professional | 53 · Discontinued | $15.85 | $16.98 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.59 Typical High $48.98 | Professional | 55 · Aftercare only | $11.75 | $12.59 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $33.11 | Professional | 56 · Pre-op care only | $7.94 | $8.51 | $33.11 |
Where Indiana sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 33rd of 51
$257
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.