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 $457.09 Median $5,011.87 Typical High $7,244.36 | Facility | None | $457.09 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $524.81 | Professional | None | $436.52 | $457.09 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $3,467.37 Typical High $12,589.25 | Facility | None | $1,258.93 | $3,467.37 | $12,589.25 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $741.31 | Professional | None | $512.86 | $645.65 | $741.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $120.23 Median $660.69 Typical High $2,187.76 | Facility | None | $120.23 | $660.69 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
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 |
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 $218.78 Median $229.09 Typical High $257.04 | Professional | 52 · Reduced service | $218.78 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $102.33 | Professional | 53 · Discontinued | $87.10 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $338.84 Typical High $389.05 | Professional | 54 · Surgery only | $323.59 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $67.61 Typical High $77.62 | Professional | 55 · Aftercare only | $64.57 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $51.29 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $51.29 |
Where Indiana sits
The same service costs 134.9 times more in Oklahoma than in Hawaii. 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· 14th of 51
$741
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.