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 $38.02 Median $5,011.87 Typical High $5,623.41 | Facility | None | $38.02 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
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 $36.31 Median $61.66 Typical High $87.10 | Professional | None | $36.31 | $61.66 | $87.10 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $616.60 Typical High $912.01 | Facility | None | $45.71 | $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 $45.71 Median $58.88 Typical High $117.49 | Professional | None | $45.71 | $58.88 | $117.49 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $109.65 Median $891.25 Typical High $2,187.76 | Facility | None | $109.65 | $891.25 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $42.66 Median $54.95 Typical High $75.86 | Professional | None | $42.66 | $54.95 | $75.86 |
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 $36.31 Median $51.29 Typical High $89.13 | Professional | None | $36.31 | $51.29 | $89.13 |
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 $19.05 Median $19.05 Typical High $22.91 | Professional | 52 · Reduced service | $19.05 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $9.12 | Professional | 53 · Discontinued | $7.59 | $7.59 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | 54 · Surgery only | $28.18 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $6.92 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $4.57 |
Where Indiana sits
The same service costs 13.8 times more in Oklahoma than in New York. 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· 30th of 51
$61.66
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.