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 $58.88 Median $1,380.38 Typical High $5,011.87 | Facility | None | $58.88 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $123.03 | Professional | None | $58.88 | $97.72 | $123.03 |
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 $46.77 Median $54.95 Typical High $77.62 | Professional | None | $46.77 | $54.95 | $77.62 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $158.49 | Facility | None | $60.26 | $60.26 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $151.36 Typical High $724.44 | Facility | None | $81.28 | $151.36 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $165.96 | Professional | None | $58.88 | $95.50 | $165.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $1,659.59 | Facility | None | $151.36 | $295.12 | $1,659.59 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $64.57 Median $114.82 Typical High $186.21 | Professional | None | $64.57 | $114.82 | $186.21 |
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 $56.23 Median $100.00 Typical High $173.78 | Professional | None | $56.23 | $100.00 | $173.78 |
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 $29.51 Median $47.86 Typical High $61.66 | Professional | 52 · Reduced service | $29.51 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $11.75 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $74.13 Typical High $93.33 | Professional | 54 · Surgery only | $43.65 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $8.71 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $10.00 Typical High $12.30 | Professional | 56 · Pre-op care only | $5.89 | $10.00 | $12.30 |
Where Indiana sits
The same service costs 3.9 times more in Wisconsin 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· 49th of 51
$89.13
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.