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 $263.03 Median $5,011.87 Typical High $11,220.18 | Facility | None | $263.03 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $263.03 Typical High $371.54 | Professional | None | $245.47 | $263.03 | $371.54 |
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 $371.54 Median $467.74 Typical High $724.44 | Professional | None | $371.54 | $467.74 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $5,623.41 Typical High $8,317.64 | Facility | None | $371.54 | $5,623.41 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $26,915.35 Typical High $44,668.36 | Facility | None | $645.65 | $26,915.35 | $44,668.36 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $40,738.03 | Facility | None | $912.01 | $954.99 | $40,738.03 |
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 $707.95 Median $1,122.02 Typical High $1,819.70 | Professional | None | $707.95 | $1,122.02 | $1,819.70 |
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 $123.03 Median $131.83 Typical High $181.97 | Professional | 52 · Reduced service | $123.03 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $52.48 Typical High $72.44 | Professional | 53 · Discontinued | $48.98 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $194.98 Typical High $275.42 | Professional | 54 · Surgery only | $181.97 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.90 Typical High $54.95 | Professional | 55 · Aftercare only | $36.31 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $26.30 Typical High $36.31 | Professional | 56 · Pre-op care only | $24.55 | $26.30 | $36.31 |
Where Indiana sits
The same service costs 50.1 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· 44th of 51
$933
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.