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 $97.72 Median $3,467.37 Typical High $5,011.87 | Facility | None | $97.72 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $120.23 | Professional | None | $91.20 | $97.72 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $158.49 Median $933.25 Typical High $1,621.81 | Facility | None | $158.49 | $933.25 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $158.49 Typical High $208.93 | Professional | None | $87.10 | $158.49 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
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 $107.15 Median $141.25 Typical High $213.80 | Professional | None | $107.15 | $141.25 | $213.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $251.19 Median $426.58 Typical High $2,089.30 | Facility | None | $251.19 | $426.58 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $190.55 | Professional | None | $104.71 | $128.82 | $190.55 |
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 $100.00 Median $131.83 Typical High $199.53 | Professional | None | $100.00 | $131.83 | $199.53 |
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 $45.71 Median $47.86 Typical High $60.26 | Professional | 52 · Reduced service | $45.71 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $18.20 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $72.44 Typical High $89.13 | Professional | 54 · Surgery only | $67.61 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.45 Typical High $17.78 | Professional | 55 · Aftercare only | $13.49 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.77 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.12 | $9.77 | $12.02 |
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· 30th of 51
$158
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.