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 $56.23 Median $3,467.37 Typical High $5,623.41 | Facility | None | $56.23 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $117.49 Typical High $141.25 | Professional | None | $56.23 | $117.49 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $112.20 Typical High $194.98 | Professional | None | $54.95 | $112.20 | $194.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $83.18 Median $169.82 Typical High $302.00 | Professional | 50 · Both sides | $83.18 | $169.82 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $1,479.11 | Facility | None | $70.79 | $70.79 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,096.48 Typical High $1,659.59 | Facility | None | $407.38 | $1,096.48 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $213.80 | Professional | None | $72.44 | $131.83 | $213.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $177.83 Median $1,548.82 Typical High $2,344.23 | Facility | None | $177.83 | $1,548.82 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $70.79 Median $141.25 Typical High $251.19 | Professional | None | $70.79 | $141.25 | $251.19 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $66.07 Median $123.03 Typical High $229.09 | Professional | None | $66.07 | $123.03 | $229.09 |
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 $28.18 Median $58.88 Typical High $70.79 | Professional | 52 · Reduced service | $28.18 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $23.44 Typical High $28.18 | Professional | 53 · Discontinued | $11.22 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $89.13 Typical High $107.15 | Professional | 54 · Surgery only | $41.69 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $17.78 Typical High $21.38 | Professional | 55 · Aftercare only | $8.32 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $11.75 Typical High $14.13 | Professional | 56 · Pre-op care only | $5.62 | $11.75 | $14.13 |
Where Indiana sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 47th 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.