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 $194.98 Median $3,801.89 Typical High $5,623.41 | Facility | None | $194.98 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $302.00 | Professional | None | $194.98 | $257.04 | $302.00 |
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 $162.18 Median $204.17 Typical High $288.40 | Professional | None | $162.18 | $204.17 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $309.03 | Facility | None | $208.93 | $208.93 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $323.59 Typical High $794.33 | Facility | None | $194.98 | $323.59 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $436.52 | Professional | None | $165.96 | $275.42 | $436.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $234.42 Median $416.87 Typical High $1,778.28 | Facility | None | $234.42 | $416.87 | $1,778.28 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $512.86 | Professional | None | $234.42 | $380.19 | $512.86 |
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 $204.17 Median $295.12 Typical High $467.74 | Professional | None | $204.17 | $295.12 | $467.74 |
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 $97.72 Median $128.82 Typical High $151.36 | Professional | 52 · Reduced service | $97.72 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $51.29 Typical High $60.26 | Professional | 53 · Discontinued | $38.90 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $190.55 Typical High $223.87 | Professional | 54 · Surgery only | $147.91 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $38.02 Typical High $45.71 | Professional | 55 · Aftercare only | $29.51 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $25.70 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.50 | $25.70 | $30.20 |
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· 40th of 51
$269
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.