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 $257.04 Median $5,011.87 Typical High $5,623.41 | Facility | None | $257.04 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $363.08 | Professional | None | $251.19 | $257.04 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $11,220.18 Typical High $23,442.29 | Facility | None | $1,318.26 | $11,220.18 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $346.74 | Professional | None | $213.80 | $302.00 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $5,623.41 | Facility | None | $263.03 | $263.03 | $5,623.41 |
CareSource Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $6,165.95 Typical High $10,471.29 | Facility | None | $691.83 | $6,165.95 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $524.81 | Professional | None | $263.03 | $316.23 | $524.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $691.83 Median $4,168.69 Typical High $10,715.19 | Facility | None | $691.83 | $4,168.69 | $10,715.19 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $478.63 | Professional | None | $263.03 | $363.08 | $478.63 |
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 $223.87 Median $288.40 Typical High $446.68 | Professional | None | $223.87 | $288.40 | $446.68 |
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 $125.89 Median $128.82 Typical High $177.83 | Professional | 52 · Reduced service | $125.89 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $51.29 Typical High $72.44 | Professional | 53 · Discontinued | $50.12 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $269.15 | Professional | 54 · Surgery only | $190.55 | $190.55 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $53.70 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.70 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.12 | $25.70 | $35.48 |
Where Indiana sits
The same service costs 4.3 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· 35th of 51
$302
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.