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 $2,344.23 Median $4,073.80 Typical High $5,011.87 | Facility | None | $2,344.23 | $4,073.80 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,897.79 | Professional | None | $4,073.80 | $4,073.80 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $4,570.88 | Professional | None | $2,754.23 | $3,235.94 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,691.53 Typical High $4,466.84 | Facility | None | $645.65 | $2,691.53 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $4,570.88 Typical High $5,754.40 | Professional | None | $3,890.45 | $4,570.88 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,715.35 Typical High $11,220.18 | Facility | None | $912.01 | $3,715.35 | $11,220.18 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $4,466.84 Median $5,248.07 Typical High $6,606.93 | Professional | None | $4,466.84 | $5,248.07 | $6,606.93 |
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 $3,801.89 Median $4,897.79 Typical High $7,585.78 | Professional | None | $3,801.89 | $4,897.79 | $7,585.78 |
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 $2,041.74 Median $2,041.74 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,041.74 | $2,041.74 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | 53 · Discontinued | $812.83 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,019.95 Typical High $3,630.78 | Professional | 54 · Surgery only | $3,019.95 | $3,019.95 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $489.78 |
Where Indiana sits
The same service costs 4.4 times more in Alaska than in Arkansas. 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· 39th of 51
$3,890
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.