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 $53.70 Median $5,011.87 Typical High $5,623.41 | Facility | None | $53.70 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $66.07 | Professional | None | $47.86 | $53.70 | $66.07 |
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 $41.69 Median $72.44 Typical High $97.72 | Professional | None | $41.69 | $72.44 | $97.72 |
CareSource Setting Facility Modifier None Typical Low $48.98 Median $616.60 Typical High $912.01 | Facility | None | $48.98 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $70.79 Typical High $346.74 | Facility | None | $50.12 | $70.79 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $109.65 | Professional | None | $47.86 | $63.10 | $109.65 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $41.69 Median $186.21 Typical High $2,187.76 | Facility | None | $41.69 | $186.21 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $81.28 | Professional | None | $51.29 | $66.07 | $81.28 |
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 $46.77 Median $64.57 Typical High $93.33 | Professional | None | $46.77 | $64.57 | $93.33 |
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 $23.99 Median $26.92 Typical High $30.20 | Professional | 52 · Reduced service | $23.99 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.72 Typical High $12.02 | Professional | 53 · Discontinued | $9.77 | $10.72 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $40.74 Typical High $44.67 | Professional | 54 · Surgery only | $36.31 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.13 Typical High $8.91 | Professional | 55 · Aftercare only | $7.24 | $8.13 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.37 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.79 | $5.37 | $6.03 |
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· 35th of 51
$72.44
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.