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 $72.44 Median $3,467.37 Typical High $5,011.87 | Facility | None | $72.44 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $112.20 | Professional | None | $72.44 | $72.44 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $6,918.31 Typical High $10,000.00 | Facility | None | $3,801.89 | $6,918.31 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $245.47 | Professional | None | $120.23 | $154.88 | $245.47 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $257.04 Typical High $407.38 | Professional | 50 · Both sides | $177.83 | $257.04 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $1,698.24 Typical High $2,570.40 | Facility | None | $114.82 | $1,698.24 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
United Setting Facility Modifier None Typical Low $3,388.44 Median $5,370.32 Typical High $8,709.64 | Facility | None | $3,388.44 | $5,370.32 | $8,709.64 |
United Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $234.42 | Professional | None | $97.72 | $151.36 | $234.42 |
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 $36.31 Median $36.31 Typical High $54.95 | Professional | 52 · Reduced service | $36.31 | $36.31 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $21.88 | Professional | 53 · Discontinued | $14.45 | $14.45 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $81.28 | Professional | 54 · Surgery only | $53.70 | $53.70 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $16.22 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $10.96 |
Where Indiana sits
The same service costs 51.3 times more in Oklahoma 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· 28th of 51
$182
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.