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 $165.96 Median $5,011.87 Typical High $5,623.41 | Facility | None | $165.96 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $234.42 | Professional | None | $158.49 | $165.96 | $234.42 |
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 $83.18 Median $186.21 Typical High $251.19 | Professional | None | $83.18 | $186.21 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $3,801.89 Typical High $5,754.40 | Facility | None | $251.19 | $3,801.89 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $19,054.61 Typical High $26,915.35 | Facility | None | $645.65 | $19,054.61 | $26,915.35 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $1,230.27 Typical High $1,230.27 | Professional | None | $302.00 | $1,230.27 | $1,230.27 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $25,118.86 | Facility | None | $912.01 | $954.99 | $25,118.86 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $467.74 | Professional | None | $208.93 | $288.40 | $467.74 |
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 $77.62 Median $83.18 Typical High $117.49 | Professional | 52 · Reduced service | $77.62 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $46.77 | Professional | 53 · Discontinued | $31.62 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $125.89 Typical High $173.78 | Professional | 54 · Surgery only | $117.49 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $25.12 Typical High $34.67 | Professional | 55 · Aftercare only | $23.44 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.60 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.85 | $16.60 | $23.44 |
Where Indiana sits
The same service costs 9.5 times more in Arkansas than in Kentucky. 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· 50th of 51
$229
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.