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 $144.54 Median $3,801.89 Typical High $5,623.41 | Facility | None | $144.54 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $245.47 | Professional | None | $144.54 | $208.93 | $245.47 |
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 $138.04 Median $186.21 Typical High $245.47 | Professional | None | $138.04 | $186.21 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $295.12 | Facility | None | $162.18 | $162.18 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $245.47 Typical High $398.11 | Facility | None | $66.07 | $245.47 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $416.87 | Professional | None | $162.18 | $223.87 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $263.03 Median $446.68 Typical High $954.99 | Facility | None | $263.03 | $446.68 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $446.68 | Professional | None | $186.21 | $316.23 | $446.68 |
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 $138.04 Median $213.80 Typical High $371.54 | Professional | None | $138.04 | $213.80 | $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 $72.44 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $72.44 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $28.84 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $109.65 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $21.88 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.45 | $20.89 | $24.55 |
Where Indiana sits
The same service costs 3.9 times more in Alaska than in Maryland. 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
$204
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.