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 $165.96 Median $5,011.87 Typical High $7,244.36 | Facility | None | $165.96 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $186.21 | Professional | None | $158.49 | $165.96 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $630.96 Typical High $2,818.38 | Facility | None | $446.68 | $630.96 | $2,818.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $323.59 | Professional | None | $141.25 | $263.03 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $831.76 Typical High $1,230.27 | Facility | None | $181.97 | $831.76 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $416.87 Typical High $2,691.53 | Facility | None | $194.98 | $416.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $1,174.90 | Professional | None | $173.78 | $218.78 | $1,174.90 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $426.58 Median $912.01 Typical High $2,187.76 | Facility | None | $426.58 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $323.59 | Professional | None | $173.78 | $245.47 | $323.59 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $316.23 | Professional | None | $147.91 | $194.98 | $316.23 |
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 $79.43 Median $83.18 Typical High $91.20 | Professional | 52 · Reduced service | $79.43 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.11 Typical High $37.15 | Professional | 53 · Discontinued | $31.62 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $123.03 Typical High $138.04 | Professional | 54 · Surgery only | $117.49 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $24.55 Typical High $27.54 | Professional | 55 · Aftercare only | $23.44 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.60 Typical High $18.62 | Professional | 56 · Pre-op care only | $15.85 | $16.60 | $18.62 |
Where Indiana sits
The same service costs 4.5 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· 33rd of 51
$224
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.