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 $85.11 Median $416.87 Typical High $5,623.41 | Facility | None | $85.11 | $416.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $186.21 Typical High $218.78 | Professional | None | $60.26 | $186.21 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $154.88 | Facility | None | $81.28 | $81.28 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $165.96 Typical High $295.12 | Professional | None | $67.61 | $165.96 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
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 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $229.09 Typical High $407.38 | Professional | None | $85.11 | $229.09 | $407.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $194.98 Median $912.01 Typical High $2,137.96 | Facility | None | $194.98 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $407.38 | Professional | None | $75.86 | $144.54 | $407.38 |
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 |
United Setting Professional Modifier None Typical Low $81.28 Median $213.80 Typical High $426.58 | Professional | None | $81.28 | $213.80 | $426.58 |
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 $30.20 Median $93.33 Typical High $109.65 | Professional | 52 · Reduced service | $30.20 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $38.02 Typical High $43.65 | Professional | 53 · Discontinued | $12.02 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $141.25 Typical High $162.18 | Professional | 54 · Surgery only | $44.67 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $28.18 Typical High $32.36 | Professional | 55 · Aftercare only | $9.12 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $18.62 Typical High $21.88 | Professional | 56 · Pre-op care only | $6.03 | $18.62 | $21.88 |
Where Indiana sits
The same service costs 4.5 times more in Oklahoma 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· 44th of 51
$200
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.