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 $104.71 Median $3,801.89 Typical High $5,623.41 | Facility | None | $104.71 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $162.18 | Professional | None | $104.71 | $138.04 | $162.18 |
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 $87.10 Median $102.33 Typical High $138.04 | Professional | None | $87.10 | $102.33 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $173.78 | Facility | None | $120.23 | $120.23 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $162.18 Typical High $575.44 | Facility | None | $66.07 | $162.18 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $309.03 | Professional | None | $117.49 | $158.49 | $309.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $181.97 Median $467.74 Typical High $2,089.30 | Facility | None | $181.97 | $467.74 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $288.40 | Professional | None | $131.83 | $204.17 | $288.40 |
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 $144.54 Typical High $245.47 | Professional | None | $102.33 | $144.54 | $245.47 |
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 $52.48 Median $69.18 Typical High $81.28 | Professional | 52 · Reduced service | $52.48 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $27.54 Typical High $32.36 | Professional | 53 · Discontinued | $20.89 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $104.71 Typical High $123.03 | Professional | 54 · Surgery only | $77.62 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.89 Typical High $24.55 | Professional | 55 · Aftercare only | $15.85 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.80 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.47 | $13.80 | $16.22 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 47th of 51
$141
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.