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 $141.25 Median $5,011.87 Typical High $5,623.41 | Facility | None | $141.25 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $181.97 | Professional | None | $128.82 | $141.25 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $1,905.46 Typical High $5,370.32 | Facility | None | $257.04 | $1,905.46 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $199.53 Typical High $204.17 | Professional | None | $102.33 | $199.53 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $489.78 | Facility | None | $128.82 | $128.82 | $489.78 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $457.09 Typical High $812.83 | Facility | None | $295.12 | $457.09 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $281.84 | Professional | None | $128.82 | $147.91 | $281.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $1,412.54 | Facility | None | $323.59 | $588.84 | $1,412.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $229.09 | Professional | None | $128.82 | $165.96 | $229.09 |
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 $109.65 Median $134.90 Typical High $223.87 | Professional | None | $109.65 | $134.90 | $223.87 |
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 $64.57 Median $69.18 Typical High $89.13 | Professional | 52 · Reduced service | $64.57 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.18 Typical High $36.31 | Professional | 53 · Discontinued | $26.30 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $104.71 Typical High $134.90 | Professional | 54 · Surgery only | $97.72 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.89 Typical High $26.92 | Professional | 55 · Aftercare only | $19.50 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.13 Typical High $18.20 | Professional | 56 · Pre-op care only | $13.18 | $14.13 | $18.20 |
Where Indiana sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 25th of 51
$170
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.