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 $45.71 Median $5,011.87 Typical High $5,623.41 | Facility | None | $45.71 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $45.71 Typical High $54.95 | Professional | None | $39.81 | $45.71 | $54.95 |
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 $30.90 Median $102.33 Typical High $138.04 | Professional | None | $30.90 | $102.33 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $39.81 Median $616.60 Typical High $912.01 | Facility | None | $39.81 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $134.90 | Professional | None | $40.74 | $50.12 | $134.90 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $93.33 Median $575.44 Typical High $2,187.76 | Facility | None | $93.33 | $575.44 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $38.90 Median $52.48 Typical High $66.07 | Professional | None | $38.90 | $52.48 | $66.07 |
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 $38.02 Median $53.70 Typical High $77.62 | Professional | None | $38.02 | $53.70 | $77.62 |
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 $19.95 Median $22.91 Typical High $25.70 | Professional | 52 · Reduced service | $19.95 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $9.12 Typical High $10.23 | Professional | 53 · Discontinued | $7.94 | $9.12 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $34.67 Typical High $38.02 | Professional | 54 · Surgery only | $30.20 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.92 Typical High $7.59 | Professional | 55 · Aftercare only | $6.03 | $6.92 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.57 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.98 | $4.57 | $5.13 |
Where Indiana sits
The same service costs 9.3 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· 9th of 51
$102
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.