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 $117.49 Median $5,011.87 Typical High $11,220.18 | Facility | None | $117.49 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $218.78 Typical High $251.19 | Professional | None | $117.49 | $218.78 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,230.27 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $338.84 | Professional | None | $128.82 | $234.42 | $338.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $346.74 Typical High $501.19 | Professional | 50 · Both sides | $194.98 | $346.74 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $3,162.28 | Facility | None | $144.54 | $144.54 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $1,862.09 Typical High $3,388.44 | Facility | None | $204.17 | $1,862.09 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $380.19 | Professional | None | $147.91 | $245.47 | $380.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $380.19 Median $2,754.23 Typical High $5,495.41 | Facility | None | $380.19 | $2,754.23 | $5,495.41 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $457.09 | Professional | None | $151.36 | $269.15 | $457.09 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $426.58 | Professional | None | $131.83 | $218.78 | $426.58 |
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 $58.88 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $58.88 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $23.44 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $87.10 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $17.78 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.75 | $21.88 | $25.12 |
Where Indiana sits
The same service costs 5.8 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
$240
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.