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 $102.33 Median $3,467.37 Typical High $5,011.87 | Facility | None | $102.33 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $2,238.72 Typical High $5,495.41 | Facility | None | $302.00 | $2,238.72 | $5,495.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $154.88 | Professional | None | $85.11 | $138.04 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $208.93 | Professional | None | $107.15 | $125.89 | $208.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $213.80 Median $275.42 Typical High $2,187.76 | Facility | None | $213.80 | $275.42 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $190.55 | Professional | None | $107.15 | $144.54 | $190.55 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $177.83 | Professional | None | $91.20 | $114.82 | $177.83 |
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 $50.12 Median $50.12 Typical High $70.79 | Professional | 52 · Reduced service | $50.12 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | 53 · Discontinued | $20.42 | $20.42 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $107.15 | Professional | 54 · Surgery only | $75.86 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $21.38 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $14.13 |
Where Indiana sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$126
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.