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 $933.25 Median $5,011.87 Typical High $11,220.18 | Facility | None | $933.25 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,479.11 | Professional | None | $870.96 | $933.25 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,288.25 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,862.09 | Professional | None | $954.99 | $1,174.90 | $1,862.09 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $24,547.09 Typical High $36,307.81 | Facility | None | $1,621.81 | $24,547.09 | $36,307.81 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,818.38 Typical High $4,677.35 | Facility | None | $645.65 | $2,818.38 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $4,570.88 | Facility | None | $912.01 | $954.99 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $4,168.69 Typical High $9,120.11 | Facility | None | $1,096.48 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,511.89 Typical High $3,715.35 | Professional | None | $1,778.28 | $2,511.89 | $3,715.35 |
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 $436.52 Median $467.74 Typical High $741.31 | Professional | 52 · Reduced service | $436.52 | $467.74 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $295.12 | Professional | 53 · Discontinued | $173.78 | $186.21 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $691.83 Typical High $1,096.48 | Professional | 54 · Surgery only | $645.65 | $691.83 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $218.78 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $147.91 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $147.91 |
Where Indiana sits
The same service costs 15.8 times more in Wisconsin than in Nebraska. 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· 45th of 51
$1,778
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.