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 $269.15 Median $5,011.87 Typical High $5,623.41 | Facility | None | $269.15 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $323.59 Typical High $537.03 | Professional | None | $93.33 | $323.59 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $691.83 Typical High $1,412.54 | Facility | None | $467.74 | $691.83 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $575.44 | Professional | None | $331.13 | $407.38 | $575.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $707.95 Median $954.99 Typical High $2,137.96 | Facility | None | $707.95 | $954.99 | $2,137.96 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $645.65 | Professional | None | $302.00 | $467.74 | $645.65 |
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 $131.83 Median $131.83 Typical High $177.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | 53 · Discontinued | $53.70 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | 54 · Surgery only | $199.53 | $199.53 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $36.31 |
Where Indiana sits
The same service costs 4.1 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· 39th of 51
$437
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.