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 $977.24 Median $5,011.87 Typical High $17,782.79 | Facility | None | $977.24 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,659.59 | Professional | None | $912.01 | $977.24 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $12,882.50 Typical High $28,840.32 | Facility | None | $1,819.70 | $12,882.50 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,148.15 | Professional | None | $831.76 | $933.25 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $2,884.03 Typical High $40,738.03 | Facility | None | $1,621.81 | $2,884.03 | $40,738.03 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,165.95 Typical High $12,022.64 | Facility | None | $645.65 | $6,165.95 | $12,022.64 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $8,511.38 | Facility | None | $912.01 | $954.99 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
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 $1,096.48 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,737.80 | $2,570.40 |
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 $457.09 Median $489.78 Typical High $812.83 | Professional | 52 · Reduced service | $457.09 | $489.78 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $323.59 | Professional | 53 · Discontinued | $181.97 | $194.98 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $239.88 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $162.18 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $162.18 |
Where Indiana sits
The same service costs 9.1 times more in Oklahoma 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· 10th of 51
$3,631
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.