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 $2,630.27 Median $2,630.27 Typical High $7,079.46 | Facility | None | $2,630.27 | $2,630.27 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,630.27 Typical High $2,818.38 | Professional | None | $2,454.71 | $2,630.27 | $2,818.38 |
Ambetter Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $891.25 | Facility | None | $467.74 | $467.74 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $724.44 | Professional | None | $398.11 | $467.74 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,290.87 | Facility | None | $1,819.70 | $1,819.70 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $2,290.87 Typical High $2,290.87 | Professional | None | $616.60 | $2,290.87 | $2,290.87 |
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 $10,964.78 Median $12,882.50 Typical High $14,454.40 | Professional | None | $10,964.78 | $12,882.50 | $14,454.40 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $8,317.64 Typical High $10,715.19 | Facility | None | $4,073.80 | $8,317.64 | $10,715.19 |
United Setting Professional Modifier None Typical Low $758.58 Median $2,570.40 Typical High $6,165.95 | Professional | None | $758.58 | $2,570.40 | $6,165.95 |
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 $1,230.27 Median $1,288.25 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,230.27 | $1,288.25 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $524.81 Typical High $562.34 | Professional | 53 · Discontinued | $489.78 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,949.84 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,819.70 | $1,949.84 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $389.05 Typical High $416.87 | Professional | 55 · Aftercare only | $363.08 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $263.03 Typical High $281.84 | Professional | 56 · Pre-op care only | $245.47 | $263.03 | $281.84 |
Where Indiana sits
The same service costs 9.3 times more in Alaska than in Indiana. 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· 51st of 51
$692
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.