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 $851.14 Median $5,011.87 Typical High $7,244.36 | Facility | None | $851.14 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,230.27 | Professional | None | $794.33 | $851.14 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,659.59 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $53.70 | Professional | None | $37.15 | $43.65 | $53.70 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $20,417.38 Typical High $30,199.52 | Facility | None | $1,348.96 | $20,417.38 | $30,199.52 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $2,691.53 | Facility | None | $524.81 | $724.44 | $2,691.53 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $5,370.32 | Facility | None | $912.01 | $954.99 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,698.24 | $2,630.27 |
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 $398.11 Median $426.58 Typical High $616.60 | Professional | 52 · Reduced service | $398.11 | $426.58 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $245.47 | Professional | 53 · Discontinued | $158.49 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $645.65 Typical High $912.01 | Professional | 54 · Surgery only | $602.56 | $645.65 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $181.97 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $123.03 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $123.03 |
Where Indiana sits
The same service costs 109.6 times more in Alaska 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· 21st of 51
$1,905
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.