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 $95.50 Median $5,011.87 Typical High $5,623.41 | Facility | None | $95.50 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $120.23 | Professional | None | $95.50 | $95.50 | $120.23 |
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 $93.33 Median $134.90 Typical High $181.97 | Professional | None | $93.33 | $134.90 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $776.25 | Facility | None | $109.65 | $109.65 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $616.60 Typical High $1,174.90 | Facility | None | $426.58 | $616.60 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $218.78 | Professional | None | $104.71 | $128.82 | $218.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $281.84 Median $912.01 Typical High $2,089.30 | Facility | None | $281.84 | $912.01 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $204.17 | Professional | None | $114.82 | $151.36 | $204.17 |
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 $95.50 Median $125.89 Typical High $194.98 | Professional | None | $95.50 | $125.89 | $194.98 |
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 $47.86 Median $47.86 Typical High $58.88 | Professional | 52 · Reduced service | $47.86 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $23.44 | Professional | 53 · Discontinued | $19.05 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $87.10 | Professional | 54 · Surgery only | $70.79 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $17.38 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $11.75 |
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
$135
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.