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 $123.03 Median $5,011.87 Typical High $7,244.36 | Facility | None | $123.03 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $151.36 | Professional | None | $109.65 | $123.03 | $151.36 |
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 $85.11 Median $151.36 Typical High $162.18 | Professional | None | $85.11 | $151.36 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $489.78 | Facility | None | $109.65 | $109.65 | $489.78 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $1,479.11 | Facility | None | $295.12 | $489.78 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $204.17 | Professional | None | $100.00 | $112.20 | $204.17 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $288.40 Median $616.60 Typical High $2,187.76 | Facility | None | $288.40 | $616.60 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $186.21 | Professional | None | $104.71 | $141.25 | $186.21 |
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 $91.20 Median $109.65 Typical High $181.97 | Professional | None | $91.20 | $109.65 | $181.97 |
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 $54.95 Median $61.66 Typical High $75.86 | Professional | 52 · Reduced service | $54.95 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $24.55 Typical High $30.20 | Professional | 53 · Discontinued | $21.88 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $81.28 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.62 Typical High $22.91 | Professional | 55 · Aftercare only | $16.22 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.30 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.96 | $12.30 | $15.14 |
Where Indiana sits
The same service costs 4.8 times more in Alaska than in Florida. 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· 29th of 51
$129
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.