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 $346.74 Median $5,011.87 Typical High $7,244.36 | Facility | None | $346.74 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $489.78 | Professional | None | $346.74 | $346.74 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,413.10 Typical High $17,378.01 | Facility | None | $758.58 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $501.19 Typical High $562.34 | Professional | None | $295.12 | $501.19 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $1,778.28 | Facility | None | $363.08 | $363.08 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,096.48 Typical High $2,187.76 | Facility | None | $489.78 | $1,096.48 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $758.58 | Professional | None | $363.08 | $457.09 | $758.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,995.26 Typical High $3,548.13 | Facility | None | $912.01 | $1,995.26 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $645.65 | Professional | None | $363.08 | $501.19 | $645.65 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $645.65 | Professional | None | $309.03 | $416.87 | $645.65 |
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 $173.78 Median $173.78 Typical High $234.42 | Professional | 52 · Reduced service | $173.78 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $95.50 | Professional | 53 · Discontinued | $69.18 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $263.03 Typical High $354.81 | Professional | 54 · Surgery only | $257.04 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $52.48 Typical High $70.79 | Professional | 55 · Aftercare only | $51.29 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $47.86 |
Where Indiana sits
The same service costs 4.8 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· 32nd of 51
$457
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.