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 $316.23 Median $5,011.87 Typical High $11,220.18 | Facility | None | $316.23 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $416.87 | Professional | None | $316.23 | $316.23 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $891.25 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $489.78 Typical High $645.65 | Professional | None | $281.84 | $489.78 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $741.31 Typical High $1,000.00 | Professional | 50 · Both sides | $426.58 | $741.31 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $3,467.37 | Facility | None | $346.74 | $346.74 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $3,630.78 | Facility | None | $512.86 | $2,089.30 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $741.31 | Professional | None | $346.74 | $426.58 | $741.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,311.31 Typical High $5,011.87 | Facility | None | $912.01 | $3,311.31 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $630.96 | Professional | None | $354.81 | $512.86 | $630.96 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $660.69 | Professional | None | $331.13 | $436.52 | $660.69 |
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 $158.49 Median $158.49 Typical High $208.93 | Professional | 52 · Reduced service | $158.49 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $83.18 | Professional | 53 · Discontinued | $63.10 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $239.88 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $63.10 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $41.69 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $41.69 |
Where Indiana sits
The same service costs 4.7 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· 37th of 51
$490
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.