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 $912.01 Median $5,011.87 Typical High $17,378.01 | Facility | None | $912.01 | $5,011.87 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $16,595.87 | Professional | None | $912.01 | $912.01 | $16,595.87 |
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 $14,791.08 Median $21,877.62 Typical High $33,113.11 | Facility | None | $14,791.08 | $21,877.62 | $33,113.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $31,622.78 | Facility | None | $912.01 | $2,290.87 | $31,622.78 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,659.59 | $10,471.29 | $26,302.68 |
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 $457.09 Median $457.09 Typical High $8,317.64 | Professional | 52 · Reduced service | $457.09 | $457.09 | $8,317.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $3,311.31 | Professional | 53 · Discontinued | $181.97 | $181.97 | $3,311.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $12,302.69 | Professional | 54 · Surgery only | $691.83 | $691.83 | $12,302.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $2,454.71 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $2,454.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $1,659.59 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $1,659.59 |
Where Indiana sits
The same service costs 5754.4 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· 5th of 51
$16,596
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.