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 $83.18 Median $1,380.38 Typical High $5,011.87 | Facility | None | $83.18 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $134.90 | Professional | None | $83.18 | $120.23 | $134.90 |
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 $89.13 Median $141.25 Typical High $199.53 | Professional | None | $89.13 | $141.25 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $141.25 Typical High $239.88 | Facility | None | $66.07 | $141.25 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $229.09 | Professional | None | $104.71 | $144.54 | $229.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $147.91 Median $251.19 Typical High $1,995.26 | Facility | None | $147.91 | $251.19 | $1,995.26 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $218.78 | Professional | None | $100.00 | $158.49 | $218.78 |
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 $91.20 Median $131.83 Typical High $213.80 | Professional | None | $91.20 | $131.83 | $213.80 |
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 $41.69 Median $57.54 Typical High $67.61 | Professional | 52 · Reduced service | $41.69 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $22.91 Typical High $26.92 | Professional | 53 · Discontinued | $16.98 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $85.11 Typical High $102.33 | Professional | 54 · Surgery only | $63.10 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $12.59 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.48 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.32 | $11.48 | $13.49 |
Where Indiana sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 34th of 51
$141
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.