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 $446.68 Median $5,011.87 Typical High $5,623.41 | Facility | None | $446.68 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $549.54 | Professional | None | $416.87 | $446.68 | $549.54 |
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 $407.38 Median $602.56 Typical High $812.83 | Professional | None | $407.38 | $602.56 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $537.03 | Facility | None | $457.09 | $457.09 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $794.33 | Facility | None | $269.15 | $426.58 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $851.14 | Professional | None | $501.19 | $588.84 | $851.14 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $407.38 Median $562.34 Typical High $1,348.96 | Facility | None | $407.38 | $562.34 | $1,348.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $912.01 | Professional | None | $489.78 | $616.60 | $912.01 |
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 $446.68 Median $588.84 Typical High $870.96 | Professional | None | $446.68 | $588.84 | $870.96 |
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 $208.93 Median $223.87 Typical High $275.42 | Professional | 52 · Reduced service | $208.93 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $109.65 | Professional | 53 · Discontinued | $83.18 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $316.23 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $54.95 |
Where Indiana sits
The same service costs 3.5 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· 29th of 51
$603
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.