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 $64.57 Median $1,380.38 Typical High $5,011.87 | Facility | None | $64.57 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $100.00 | Professional | None | $64.57 | $83.18 | $100.00 |
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 $61.66 Median $77.62 Typical High $102.33 | Professional | None | $61.66 | $77.62 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $138.04 | Facility | None | $70.79 | $70.79 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $109.65 Typical High $194.98 | Facility | None | $66.07 | $109.65 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $186.21 | Professional | None | $67.61 | $89.13 | $186.21 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $125.89 Median $281.84 Typical High $954.99 | Facility | None | $125.89 | $281.84 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $194.98 | Professional | None | $85.11 | $131.83 | $194.98 |
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 $56.23 Median $85.11 Typical High $147.91 | Professional | None | $56.23 | $85.11 | $147.91 |
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 $31.62 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $31.62 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.60 Typical High $19.95 | Professional | 53 · Discontinued | $12.88 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $63.10 Typical High $74.13 | Professional | 54 · Surgery only | $47.86 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $9.55 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.32 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.46 | $8.32 | $10.00 |
Where Indiana sits
The same service costs 3.8 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· 45th of 51
$83.18
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.