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 $138.04 Median $3,801.89 Typical High $5,623.41 | Facility | None | $138.04 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $331.13 | Professional | None | $138.04 | $245.47 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $2,570.40 | Facility | None | $165.96 | $165.96 | $2,570.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $234.42 | Professional | None | $125.89 | $165.96 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $549.54 | Professional | None | $158.49 | $281.84 | $549.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $389.05 Median $912.01 Typical High $2,187.76 | Facility | None | $389.05 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $162.18 Median $316.23 Typical High $524.81 | Professional | None | $162.18 | $316.23 | $524.81 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $4,570.88 | Facility | None | $933.25 | $2,290.87 | $4,570.88 |
United Setting Professional Modifier None Typical Low $158.49 Median $302.00 Typical High $549.54 | Professional | None | $158.49 | $302.00 | $549.54 |
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 $69.18 Median $120.23 Typical High $162.18 | Professional | 52 · Reduced service | $69.18 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $48.98 Typical High $64.57 | Professional | 53 · Discontinued | $27.54 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $181.97 Typical High $239.88 | Professional | 54 · Surgery only | $104.71 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $36.31 Typical High $48.98 | Professional | 55 · Aftercare only | $20.89 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $24.55 Typical High $32.36 | Professional | 56 · Pre-op care only | $13.80 | $24.55 | $32.36 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 49th of 51
$209
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.