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 $100.00 Median $5,011.87 Typical High $5,623.41 | Facility | None | $100.00 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $125.89 | Professional | None | $100.00 | $100.00 | $125.89 |
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 $97.72 Median $144.54 Typical High $194.98 | Professional | None | $97.72 | $144.54 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $776.25 | Facility | None | $117.49 | $117.49 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $512.86 Typical High $1,023.29 | Facility | None | $162.18 | $512.86 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $208.93 | Professional | None | $102.33 | $134.90 | $208.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $295.12 Median $912.01 Typical High $2,089.30 | Facility | None | $295.12 | $912.01 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $213.80 | Professional | None | $120.23 | $154.88 | $213.80 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $204.17 | Professional | None | $102.33 | $128.82 | $204.17 |
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 $50.12 Median $50.12 Typical High $63.10 | Professional | 52 · Reduced service | $50.12 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $25.12 | Professional | 53 · Discontinued | $19.95 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $75.86 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $12.59 |
Where Indiana sits
The same service costs 4.4 times more in Alaska than in New York. 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· 43rd of 51
$145
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.