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 $165.96 Median $1,380.38 Typical High $5,011.87 | Facility | None | $165.96 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $295.12 | Professional | None | $165.96 | $245.47 | $295.12 |
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 $151.36 Median $186.21 Typical High $245.47 | Professional | None | $151.36 | $186.21 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $295.12 | Facility | None | $186.21 | $186.21 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $234.42 Typical High $398.11 | Facility | None | $66.07 | $234.42 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $524.81 | Professional | None | $177.83 | $239.88 | $524.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $263.03 Median $489.78 Typical High $1,000.00 | Facility | None | $263.03 | $489.78 | $1,000.00 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $199.53 Median $363.08 Typical High $524.81 | Professional | None | $199.53 | $363.08 | $524.81 |
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 $154.88 Median $239.88 Typical High $426.58 | Professional | None | $154.88 | $239.88 | $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 $83.18 Median $123.03 Typical High $147.91 | Professional | 52 · Reduced service | $83.18 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $48.98 Typical High $58.88 | Professional | 53 · Discontinued | $33.11 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $186.21 Typical High $218.78 | Professional | 54 · Surgery only | $125.89 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $37.15 Typical High $44.67 | Professional | 55 · Aftercare only | $25.12 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $24.55 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.60 | $24.55 | $29.51 |
Where Indiana sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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
$219
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.