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 $134.90 Median $5,011.87 Typical High $5,623.41 | Facility | None | $134.90 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $158.49 | Professional | None | $117.49 | $134.90 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $7,413.10 Typical High $17,378.01 | Facility | None | $741.31 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $245.47 | Professional | None | $95.50 | $186.21 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $3,311.31 | Facility | None | $117.49 | $117.49 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $2,630.27 Typical High $4,466.84 | Facility | None | $407.38 | $2,630.27 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $251.19 | Professional | None | $120.23 | $154.88 | $251.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $316.23 Median $3,388.44 Typical High $5,248.07 | Facility | None | $316.23 | $3,388.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $204.17 | Professional | None | $120.23 | $158.49 | $204.17 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $229.09 | Professional | None | $112.20 | $154.88 | $229.09 |
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 $58.88 Median $67.61 Typical High $79.43 | Professional | 52 · Reduced service | $58.88 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $27.54 Typical High $31.62 | Professional | 53 · Discontinued | $23.44 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $102.33 Typical High $117.49 | Professional | 54 · Surgery only | $89.13 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.42 Typical High $23.44 | Professional | 55 · Aftercare only | $17.78 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.49 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.75 | $13.49 | $15.85 |
Where Indiana sits
The same service costs 12.9 times more in Arkansas 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
$204
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.