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 $64.57 Median $3,467.37 Typical High $5,011.87 | Facility | None | $64.57 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $87.10 | Professional | None | $64.57 | $64.57 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $50.12 Typical High $77.62 | Professional | None | $42.66 | $50.12 | $77.62 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $575.44 Typical High $954.99 | Facility | None | $66.07 | $575.44 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $85.11 Typical High $128.82 | Professional | None | $44.67 | $85.11 | $128.82 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $2,089.30 | Facility | None | $512.86 | $891.25 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $117.49 | Professional | None | $69.18 | $81.28 | $117.49 |
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 $58.88 Median $77.62 Typical High $125.89 | Professional | None | $58.88 | $77.62 | $125.89 |
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 $32.36 Median $32.36 Typical High $39.81 | Professional | 52 · Reduced service | $32.36 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $15.85 | Professional | 53 · Discontinued | $12.88 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $60.26 | Professional | 54 · Surgery only | $47.86 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $12.02 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $7.94 |
Where Indiana sits
The same service costs 5.5 times more in Arkansas than in Kentucky. 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· 46th of 51
$75.86
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.