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 $245.47 Median $5,011.87 Typical High $11,220.18 | Facility | None | $245.47 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $323.59 | Professional | None | $245.47 | $245.47 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $457.09 | Professional | None | $218.78 | $346.74 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $3,467.37 | Facility | None | $269.15 | $269.15 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,570.40 Typical High $3,715.35 | Facility | None | $630.96 | $2,570.40 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $524.81 | Professional | None | $257.04 | $323.59 | $524.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $707.95 Median $3,548.13 Typical High $5,011.87 | Facility | None | $707.95 | $3,548.13 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $478.63 | Professional | None | $269.15 | $398.11 | $478.63 |
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 $257.04 Median $316.23 Typical High $512.86 | Professional | None | $257.04 | $316.23 | $512.86 |
3 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 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $186.21 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $48.98 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $32.36 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $32.36 |
Where Indiana sits
The same service costs 7.2 times more in Oklahoma 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· 44th of 51
$347
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.