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 $173.78 Median $3,467.37 Typical High $5,011.87 | Facility | None | $173.78 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $213.80 | Professional | None | $162.18 | $173.78 | $213.80 |
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 $158.49 Median $281.84 Typical High $371.54 | Professional | None | $158.49 | $281.84 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $338.84 | Facility | None | $204.17 | $204.17 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $263.03 Typical High $467.74 | Facility | None | $66.07 | $263.03 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $407.38 | Professional | None | $199.53 | $239.88 | $407.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $269.15 Median $436.52 Typical High $1,000.00 | Facility | None | $269.15 | $436.52 | $1,000.00 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $354.81 | Professional | None | $190.55 | $239.88 | $354.81 |
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 $186.21 Median $239.88 Typical High $354.81 | Professional | None | $186.21 | $239.88 | $354.81 |
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 $81.28 Median $87.10 Typical High $107.15 | Professional | 52 · Reduced service | $81.28 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $34.67 Typical High $42.66 | Professional | 53 · Discontinued | $32.36 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $128.82 Typical High $158.49 | Professional | 54 · Surgery only | $123.03 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $26.30 Typical High $31.62 | Professional | 55 · Aftercare only | $24.55 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.22 | $17.38 | $21.38 |
Where Indiana sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 21st of 51
$282
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.