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 $190.55 Median $3,467.37 Typical High $5,011.87 | Facility | None | $190.55 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $234.42 | Professional | None | $181.97 | $190.55 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $1,621.81 Typical High $50,118.72 | Facility | None | $275.42 | $1,621.81 | $50,118.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $371.54 | Professional | None | $147.91 | $275.42 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,318.26 Typical High $27,542.29 | Facility | None | $512.86 | $1,318.26 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $380.19 | Professional | None | $190.55 | $234.42 | $380.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $371.54 Median $478.63 Typical High $2,187.76 | Facility | None | $371.54 | $478.63 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $309.03 | Professional | None | $181.97 | $234.42 | $309.03 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $371.54 | Professional | None | $177.83 | $223.87 | $371.54 |
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 $91.20 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $91.20 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $37.15 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $141.25 Typical High $177.83 | Professional | 54 · Surgery only | $138.04 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $35.48 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $23.44 |
Where Indiana sits
The same service costs 3.8 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· 27th of 51
$275
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.