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 $691.83 Median $3,467.37 Typical High $5,011.87 | Facility | None | $691.83 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $23,988.33 | Professional | None | $691.83 | $691.83 | $23,988.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $33,884.42 Typical High $52,480.75 | Facility | None | $2,570.40 | $33,884.42 | $52,480.75 |
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 |
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 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,691.53 Typical High $21,379.62 | Facility | None | $302.00 | $2,691.53 | $21,379.62 |
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 $346.74 Median $346.74 Typical High $12,022.64 | Professional | 52 · Reduced service | $346.74 | $346.74 | $12,022.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $4,786.30 | Professional | 53 · Discontinued | $138.04 | $138.04 | $4,786.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $17,782.79 | Professional | 54 · Surgery only | $512.86 | $512.86 | $17,782.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $3,630.78 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $3,630.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $2,398.83 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $2,398.83 |
Where Indiana sits
The same service costs 6025.6 times more in Oklahoma than in Maine. 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· 11th of 51
$7,762
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.