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 $524.81 Median $5,011.87 Typical High $5,623.41 | Facility | None | $524.81 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $691.83 | Professional | None | $524.81 | $524.81 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,479.11 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $851.14 Typical High $1,122.02 | Professional | None | $457.09 | $851.14 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $1,288.25 Typical High $1,737.80 | Professional | 50 · Both sides | $691.83 | $1,288.25 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $10,000.00 | Facility | None | $575.44 | $575.44 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $6,456.54 Typical High $10,715.19 | Facility | None | $602.56 | $6,456.54 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,122.02 | Professional | None | $537.03 | $707.95 | $1,122.02 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,380.38 Median $8,511.38 Typical High $13,489.63 | Facility | None | $1,380.38 | $8,511.38 | $13,489.63 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,023.29 | Professional | None | $575.44 | $851.14 | $1,023.29 |
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 $537.03 Median $676.08 Typical High $1,071.52 | Professional | None | $537.03 | $676.08 | $1,071.52 |
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 $263.03 Median $263.03 Typical High $346.74 | Professional | 52 · Reduced service | $263.03 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $138.04 | Professional | 53 · Discontinued | $104.71 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $512.86 | Professional | 54 · Surgery only | $389.05 | $389.05 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $102.33 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $69.18 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $69.18 |
Where Indiana sits
The same service costs 3.9 times more in Alaska than in New York. 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· 23rd of 51
$851
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.