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 $154.88 Median $5,011.87 Typical High $5,623.41 | Facility | None | $154.88 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $186.21 | Professional | None | $144.54 | $154.88 | $186.21 |
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 $141.25 Median $251.19 Typical High $331.13 | Professional | None | $141.25 | $251.19 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $338.84 | Facility | None | $181.97 | $181.97 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $281.84 Typical High $436.52 | Facility | None | $194.98 | $281.84 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $331.13 | Professional | None | $169.82 | $208.93 | $331.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $1,000.00 | Facility | None | $269.15 | $426.58 | $1,000.00 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $316.23 | Professional | None | $169.82 | $213.80 | $316.23 |
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 $165.96 Median $213.80 Typical High $309.03 | Professional | None | $165.96 | $213.80 | $309.03 |
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 $72.44 Median $77.62 Typical High $93.33 | Professional | 52 · Reduced service | $72.44 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.90 Typical High $38.02 | Professional | 53 · Discontinued | $28.84 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $114.82 Typical High $141.25 | Professional | 54 · Surgery only | $107.15 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.91 Typical High $28.18 | Professional | 55 · Aftercare only | $21.38 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.45 | $15.49 | $18.62 |
Where Indiana sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 22nd of 51
$251
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.