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 $660.69 Median $5,011.87 Typical High $11,220.18 | Facility | None | $660.69 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,380.38 | Professional | None | $660.69 | $660.69 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $281.84 | Professional | None | $169.82 | $199.53 | $281.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $302.00 Typical High $446.68 | Professional | 50 · Both sides | $257.04 | $302.00 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $4,073.80 | Facility | None | $239.88 | $239.88 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,691.53 Typical High $4,168.69 | Facility | None | $630.96 | $2,691.53 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $616.60 | Professional | None | $158.49 | $263.03 | $616.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $4,168.69 Typical High $5,888.44 | Facility | None | $954.99 | $4,168.69 | $5,888.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $323.59 | Professional | None | $257.04 | $275.42 | $323.59 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $331.13 Median $331.13 Typical High $691.83 | Professional | 52 · Reduced service | $331.13 | $331.13 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $275.42 | Professional | 53 · Discontinued | $131.83 | $131.83 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $1,023.29 | Professional | 54 · Surgery only | $489.78 | $489.78 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $208.93 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $138.04 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $138.04 |
Where Indiana sits
The same service costs 67.6 times more in Oklahoma than in Montana. 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
$575
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.