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 $3,162.28 Median $3,162.28 Typical High $8,511.38 | Facility | None | $3,162.28 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,162.28 Typical High $3,467.37 | Professional | None | $3,019.95 | $3,162.28 | $3,467.37 |
Ambetter Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,778.28 | Facility | None | $933.25 | $933.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,445.44 | Professional | None | $794.33 | $933.25 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,818.38 | Facility | None | $2,290.87 | $2,290.87 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $2,951.21 Typical High $2,951.21 | Professional | None | $1,230.27 | $2,951.21 | $2,951.21 |
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 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $12,022.64 Median $14,454.40 Typical High $15,848.93 | Professional | None | $12,022.64 | $14,454.40 | $15,848.93 |
United Setting Facility Modifier None Typical Low $4,466.84 Median $10,000.00 Typical High $13,489.63 | Facility | None | $4,466.84 | $10,000.00 | $13,489.63 |
United Setting Professional Modifier None Typical Low $467.74 Median $3,311.31 Typical High $8,317.64 | Professional | None | $467.74 | $3,311.31 | $8,317.64 |
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 $1,513.56 Median $1,584.89 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,513.56 | $1,584.89 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $630.96 Typical High $676.08 | Professional | 53 · Discontinued | $602.56 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,398.83 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,238.72 | $2,398.83 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $478.63 Typical High $512.86 | Professional | 55 · Aftercare only | $446.68 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $316.23 Typical High $338.84 | Professional | 56 · Pre-op care only | $302.00 | $316.23 | $338.84 |
Where Indiana sits
The same service costs 14.1 times more in Alaska than in Missouri. 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· 49th of 51
$1,259
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.