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 $58.88 Median $1,380.38 Typical High $5,011.87 | Facility | None | $58.88 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $114.82 Typical High $169.82 | Professional | None | $58.88 | $114.82 | $169.82 |
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 $60.26 Median $112.20 Typical High $173.78 | Professional | None | $60.26 | $112.20 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $616.60 Typical High $912.01 | Facility | None | $72.44 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $194.98 | Professional | None | $74.13 | $112.20 | $194.98 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $165.96 Median $575.44 Typical High $2,089.30 | Facility | None | $165.96 | $575.44 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $208.93 | Professional | None | $77.62 | $123.03 | $208.93 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $218.78 | Professional | None | $64.57 | $112.20 | $218.78 |
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 $29.51 Median $50.12 Typical High $69.18 | Professional | 52 · Reduced service | $29.51 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $20.42 Typical High $27.54 | Professional | 53 · Discontinued | $11.75 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $75.86 Typical High $104.71 | Professional | 54 · Surgery only | $44.67 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $15.14 Typical High $20.89 | Professional | 55 · Aftercare only | $8.91 | $15.14 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $10.00 Typical High $13.80 | Professional | 56 · Pre-op care only | $5.89 | $10.00 | $13.80 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 32nd of 51
$132
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.