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 $47.86 Median $1,380.38 Typical High $5,011.87 | Facility | None | $47.86 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $257.04 | Professional | None | $47.86 | $47.86 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,162.28 | Facility | None | $1,621.81 | $1,621.81 | $3,162.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,621.81 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,089.30 Typical High $2,691.53 | Facility | None | $524.81 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $2,137.96 | Professional | None | $5.50 | $5.50 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
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 $23.99 Median $23.99 Typical High $128.82 | Professional | 52 · Reduced service | $23.99 | $23.99 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $51.29 | Professional | 53 · Discontinued | $9.55 | $9.55 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $36.31 Typical High $194.98 | Professional | 54 · Surgery only | $36.31 | $36.31 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $38.90 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $25.70 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $25.70 |
Where Indiana sits
The same service costs 281.8 times more in North Dakota than in Vermont. 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· 4th of 51
$1,380
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.