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 $31.62 Median $5,011.87 Typical High $5,623.41 | Facility | None | $31.62 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $56.23 | Professional | None | $31.62 | $31.62 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $38.02 Typical High $61.66 | Professional | None | $36.31 | $38.02 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $269.15 | Facility | None | $57.54 | $57.54 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $275.42 Typical High $1,412.54 | Facility | None | $165.96 | $275.42 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $58.88 Typical High $77.62 | Professional | None | $36.31 | $58.88 | $77.62 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $204.17 Median $338.84 Typical High $2,089.30 | Facility | None | $204.17 | $338.84 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $41.69 Median $64.57 Typical High $100.00 | Professional | None | $41.69 | $64.57 | $100.00 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $20.89 Median $27.54 Typical High $48.98 | Professional | None | $20.89 | $27.54 | $48.98 |
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 $15.85 Median $15.85 Typical High $27.54 | Professional | 52 · Reduced service | $15.85 | $15.85 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $11.22 | Professional | 53 · Discontinued | $6.31 | $6.31 | $11.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $23.99 Typical High $41.69 | Professional | 54 · Surgery only | $23.99 | $23.99 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $8.32 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $5.62 |
Where Indiana sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 3rd of 51
$182
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.