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 $63.10 Median $3,801.89 Typical High $5,623.41 | Facility | None | $63.10 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $138.04 Typical High $169.82 | Professional | None | $63.10 | $138.04 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $5,370.32 Typical High $9,549.93 | Facility | None | $724.44 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $141.25 Typical High $181.97 | Professional | None | $67.61 | $141.25 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $257.04 | Facility | None | $66.07 | $66.07 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $288.40 Typical High $1,479.11 | Facility | None | $173.78 | $288.40 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $147.91 Typical High $269.15 | Professional | None | $66.07 | $147.91 | $269.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $181.97 Median $371.54 Typical High $2,187.76 | Facility | None | $181.97 | $371.54 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $77.62 Median $165.96 Typical High $275.42 | Professional | None | $77.62 | $165.96 | $275.42 |
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 $61.66 Median $120.23 Typical High $199.53 | Professional | None | $61.66 | $120.23 | $199.53 |
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 $31.62 Median $66.07 Typical High $85.11 | Professional | 52 · Reduced service | $31.62 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $26.92 Typical High $33.88 | Professional | 53 · Discontinued | $12.59 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $109.65 Typical High $128.82 | Professional | 54 · Surgery only | $46.77 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $19.95 Typical High $25.70 | Professional | 55 · Aftercare only | $9.33 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $13.18 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.31 | $13.18 | $16.98 |
Where Indiana sits
The same service costs 3.7 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· 35th of 51
$138
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.