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 $199.53 Median $5,011.87 Typical High $11,220.18 | Facility | None | $199.53 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $245.47 | Professional | None | $194.98 | $199.53 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $12,022.64 Typical High $28,840.32 | Facility | None | $1,621.81 | $12,022.64 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $416.87 Typical High $549.54 | Professional | None | $169.82 | $416.87 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $4,365.16 Typical High $7,413.10 | Facility | None | $338.84 | $4,365.16 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $457.09 | Professional | None | $213.80 | $288.40 | $457.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $10,000.00 | Facility | None | $912.01 | $954.99 | $10,000.00 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $338.84 | Professional | None | $186.21 | $269.15 | $338.84 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $4,168.69 Typical High $9,120.11 | Facility | None | $1,096.48 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $398.11 | Professional | None | $204.17 | $295.12 | $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 $97.72 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $39.81 Typical High $46.77 | Professional | 53 · Discontinued | $38.90 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $147.91 Typical High $169.82 | Professional | 54 · Surgery only | $144.54 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $34.67 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.95 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.50 | $19.95 | $23.44 |
Where Indiana sits
The same service costs 6.9 times more in Tennessee than in New York. 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· 14th of 51
$417
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.