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 $77.62 Median $5,011.87 Typical High $5,623.41 | Facility | None | $77.62 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $97.72 | Professional | None | $77.62 | $77.62 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $5,623.41 Typical High $9,120.11 | Facility | None | $1,380.38 | $5,623.41 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $162.18 | Professional | None | $66.07 | $104.71 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $524.81 Typical High $2,691.53 | Facility | None | $102.33 | $524.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $194.98 | Professional | None | $83.18 | $117.49 | $194.98 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $169.82 Median $213.80 Typical High $2,187.76 | Facility | None | $169.82 | $213.80 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $144.54 | Professional | None | $81.28 | $102.33 | $144.54 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $144.54 | Professional | None | $77.62 | $109.65 | $144.54 |
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 $38.90 Median $38.90 Typical High $45.71 | Professional | 52 · Reduced service | $38.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $18.62 | Professional | 53 · Discontinued | $15.49 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $58.88 Typical High $69.18 | Professional | 54 · Surgery only | $57.54 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $13.80 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $9.12 |
Where Indiana sits
The same service costs 6.5 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· 30th of 51
$126
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.