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 $109.65 Median $3,467.37 Typical High $5,011.87 | Facility | None | $109.65 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | None | $109.65 | $109.65 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $9,120.11 | Facility | None | $1,380.38 | $5,370.32 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $234.42 Typical High $316.23 | Professional | None | $100.00 | $234.42 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $2,691.53 | Facility | None | $524.81 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $257.04 | Professional | None | $114.82 | $147.91 | $257.04 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $251.19 Median $316.23 Typical High $2,187.76 | Facility | None | $251.19 | $316.23 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $218.78 | Professional | None | $123.03 | $165.96 | $218.78 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $229.09 | Professional | None | $114.82 | $151.36 | $229.09 |
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 $54.95 Median $54.95 Typical High $69.18 | Professional | 52 · Reduced service | $54.95 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $27.54 | Professional | 53 · Discontinued | $21.88 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $104.71 | Professional | 54 · Surgery only | $83.18 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $20.89 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $13.80 |
Where Indiana sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 11th of 51
$234
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.