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 $363.08 Median $5,011.87 Typical High $5,623.41 | Facility | None | $363.08 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $407.38 | Professional | None | $331.13 | $363.08 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $10,000.00 | Facility | None | $741.31 | $5,370.32 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $602.56 | Professional | None | $389.05 | $457.09 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $2,691.53 | Facility | None | $524.81 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $4,168.69 | Professional | None | $275.42 | $416.87 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,290.87 | Facility | None | $912.01 | $954.99 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $144.54 Median $467.74 Typical High $724.44 | Professional | None | $144.54 | $467.74 | $724.44 |
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 $309.03 Median $398.11 Typical High $691.83 | Professional | None | $309.03 | $398.11 | $691.83 |
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 $165.96 Median $181.97 Typical High $199.53 | Professional | 52 · Reduced service | $165.96 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $79.43 | Professional | 53 · Discontinued | $66.07 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $302.00 | Professional | 54 · Surgery only | $245.47 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $60.26 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $39.81 |
Where Indiana sits
The same service costs 4.6 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· 38th of 51
$457
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.