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 $1,380.38 Typical High $5,623.41 | Facility | None | $64.57 | $1,380.38 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $128.82 Typical High $151.36 | Professional | None | $64.57 | $128.82 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $134.90 | Facility | None | $70.79 | $70.79 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $120.23 Typical High $169.82 | Professional | None | $60.26 | $120.23 | $169.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $177.83 Typical High $269.15 | Professional | 50 · Both sides | $91.20 | $177.83 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $269.15 | Professional | None | $81.28 | $154.88 | $269.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $186.21 Median $457.09 Typical High $2,187.76 | Facility | None | $186.21 | $457.09 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $83.18 Median $162.18 Typical High $269.15 | Professional | None | $83.18 | $162.18 | $269.15 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $4,570.88 | Facility | None | $933.25 | $2,290.87 | $4,570.88 |
United Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $263.03 | Professional | None | $75.86 | $144.54 | $263.03 |
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 $64.57 Typical High $75.86 | Professional | 52 · Reduced service | $32.36 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $12.88 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $97.72 Typical High $112.20 | Professional | 54 · Surgery only | $47.86 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $19.50 Typical High $22.91 | Professional | 55 · Aftercare only | $9.55 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.46 | $12.88 | $15.14 |
Where Indiana sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 47th of 51
$126
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.