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 $117.49 Median $1,380.38 Typical High $7,244.36 | Facility | None | $117.49 | $1,380.38 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $234.42 Typical High $302.00 | Professional | None | $117.49 | $234.42 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $263.03 | Professional | None | $95.50 | $169.82 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $1,659.59 | Facility | None | $123.03 | $123.03 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,258.93 Typical High $2,187.76 | Facility | None | $549.54 | $1,258.93 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $389.05 | Professional | None | $125.89 | $213.80 | $389.05 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $323.59 Median $1,698.24 Typical High $2,511.89 | Facility | None | $323.59 | $1,698.24 | $2,511.89 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $457.09 | Professional | None | $128.82 | $239.88 | $457.09 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $398.11 | Professional | None | $117.49 | $213.80 | $398.11 |
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 $58.88 Median $117.49 Typical High $151.36 | Professional | 52 · Reduced service | $58.88 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $46.77 Typical High $60.26 | Professional | 53 · Discontinued | $23.44 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $173.78 Typical High $223.87 | Professional | 54 · Surgery only | $87.10 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $35.48 Typical High $44.67 | Professional | 55 · Aftercare only | $17.38 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $23.44 Typical High $30.20 | Professional | 56 · Pre-op care only | $11.75 | $23.44 | $30.20 |
Where Indiana sits
The same service costs 3.9 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· 50th of 51
$200
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.