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 $1,380.38 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,380.38 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $4,677.35 Median $15,135.61 Typical High $15,135.61 | Professional | None | $4,677.35 | $15,135.61 | $15,135.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $16,595.87 Typical High $33,884.42 | Facility | None | $2,630.27 | $16,595.87 | $33,884.42 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $2,691.53 | Facility | None | $524.81 | $724.44 | $2,691.53 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,137.96 Typical High $22,387.21 | Facility | None | $912.01 | $2,137.96 | $22,387.21 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
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 $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | 52 · Reduced service | $7,585.78 | $7,585.78 | $7,585.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 53 · Discontinued | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | 54 · Surgery only | $11,481.54 | $11,481.54 | $11,481.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 55 · Aftercare only | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 56 · Pre-op care only | $1,513.56 | $1,513.56 | $1,513.56 |
Where Indiana sits
The same service costs 6.9 times more in Michigan than in Arkansas. 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· 9th of 51
$13,490
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.