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 $79.43 Median $3,801.89 Typical High $5,623.41 | Facility | None | $79.43 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $194.98 | Professional | None | $79.43 | $177.83 | $194.98 |
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 $61.66 Median $131.83 Typical High $181.97 | Professional | None | $61.66 | $131.83 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $269.15 | Facility | None | $83.18 | $83.18 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $281.84 Typical High $1,479.11 | Facility | None | $169.82 | $281.84 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $194.98 Typical High $309.03 | Professional | None | $85.11 | $194.98 | $309.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $204.17 Median $316.23 Typical High $1,348.96 | Facility | None | $204.17 | $316.23 | $1,348.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $302.00 | Professional | None | $89.13 | $134.90 | $302.00 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $79.43 Median $158.49 Typical High $275.42 | Professional | None | $79.43 | $158.49 | $275.42 |
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 $39.81 Median $89.13 Typical High $97.72 | Professional | 52 · Reduced service | $39.81 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $35.48 Typical High $38.90 | Professional | 53 · Discontinued | $15.85 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $131.83 Typical High $144.54 | Professional | 54 · Surgery only | $60.26 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $26.30 Typical High $28.84 | Professional | 55 · Aftercare only | $12.02 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $17.78 Typical High $19.50 | Professional | 56 · Pre-op care only | $7.94 | $17.78 | $19.50 |
Where Indiana sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 45th of 51
$141
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.