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 $131.83 Median $1,380.38 Typical High $5,011.87 | Facility | None | $131.83 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $257.04 | Professional | None | $131.83 | $218.78 | $257.04 |
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 $128.82 Median $165.96 Typical High $218.78 | Professional | None | $128.82 | $165.96 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $295.12 | Facility | None | $147.91 | $147.91 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $213.80 Typical High $398.11 | Facility | None | $66.07 | $213.80 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $426.58 | Professional | None | $144.54 | $218.78 | $426.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $263.03 Median $407.38 Typical High $954.99 | Facility | None | $263.03 | $407.38 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $467.74 | Professional | None | $169.82 | $302.00 | $467.74 |
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 $125.89 Median $208.93 Typical High $371.54 | Professional | None | $125.89 | $208.93 | $371.54 |
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 $66.07 Median $107.15 Typical High $128.82 | Professional | 52 · Reduced service | $66.07 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $26.30 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $100.00 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $19.95 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.18 | $21.88 | $25.70 |
Where Indiana sits
The same service costs 4.1 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
$191
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.