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 $234.42 Median $5,011.87 Typical High $7,244.36 | Facility | None | $234.42 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $389.05 | Professional | None | $218.78 | $234.42 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,288.25 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $123.03 | Professional | None | $77.62 | $91.20 | $123.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $134.90 Typical High $186.21 | Professional | 50 · Both sides | $114.82 | $134.90 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $6,456.54 Typical High $9,772.37 | Facility | None | $426.58 | $6,456.54 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,630.78 Typical High $6,760.83 | Facility | None | $645.65 | $3,630.78 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $2,089.30 Typical High $2,089.30 | Professional | None | $81.28 | $2,089.30 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $4,897.79 | Facility | None | $912.01 | $954.99 | $4,897.79 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $245.47 | Professional | None | $144.54 | $177.83 | $245.47 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $4,168.69 Typical High $9,120.11 | Facility | None | $1,096.48 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $676.08 | Professional | None | $295.12 | $398.11 | $676.08 |
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 $109.65 Median $117.49 Typical High $194.98 | Professional | 52 · Reduced service | $109.65 | $117.49 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $46.77 Typical High $77.62 | Professional | 53 · Discontinued | $43.65 | $46.77 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $173.78 Typical High $295.12 | Professional | 54 · Surgery only | $162.18 | $173.78 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $35.48 Typical High $58.88 | Professional | 55 · Aftercare only | $33.11 | $35.48 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.44 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $23.44 | $38.90 |
Where Indiana sits
The same service costs 28.2 times more in Texas 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· 46th of 51
$234
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.