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 $512.86 Median $5,011.87 Typical High $11,220.18 | Facility | None | $512.86 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | None | $512.86 | $512.86 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,479.11 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,412.54 | Professional | None | $851.14 | $1,000.00 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,412.54 | Facility | None | $933.25 | $1,288.25 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $741.31 Typical High $2,691.53 | Facility | None | $489.78 | $741.31 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,318.26 Typical High $1,318.26 | Professional | None | $707.95 | $1,318.26 | $1,318.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,290.87 | Facility | None | $912.01 | $954.99 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,047.13 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $257.04 Median $257.04 Typical High $281.84 | Professional | 52 · Reduced service | $257.04 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 53 · Discontinued | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | 54 · Surgery only | $389.05 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $56.23 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $56.23 |
Where Indiana sits
The same service costs 346.7 times more in Oklahoma than in Hawaii. 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· 34th of 51
$1,023
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.