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 $107.15 Median $3,467.37 Typical High $5,623.41 | Facility | None | $107.15 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $223.87 | Professional | None | $107.15 | $204.17 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $223.87 | Professional | None | $100.00 | $173.78 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $1,318.26 | Facility | None | $112.20 | $112.20 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $977.24 Typical High $1,659.59 | Facility | None | $407.38 | $977.24 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $331.13 | Professional | None | $104.71 | $169.82 | $331.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $295.12 Median $1,380.38 Typical High $2,187.76 | Facility | None | $295.12 | $1,380.38 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $363.08 | Professional | None | $128.82 | $229.09 | $363.08 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $288.40 | Professional | None | $102.33 | $173.78 | $288.40 |
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 $53.70 Median $100.00 Typical High $112.20 | Professional | 52 · Reduced service | $53.70 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $39.81 Typical High $44.67 | Professional | 53 · Discontinued | $21.38 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $147.91 Typical High $165.96 | Professional | 54 · Surgery only | $81.28 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $30.20 Typical High $33.11 | Professional | 55 · Aftercare only | $16.22 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $19.95 Typical High $22.39 | Professional | 56 · Pre-op care only | $10.72 | $19.95 | $22.39 |
Where Indiana sits
The same service costs 3.8 times more in Alaska than in Washington, DC. 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· 39th of 51
$178
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.