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 $131.83 Median $3,467.37 Typical High $7,244.36 | Facility | None | $131.83 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $239.88 Typical High $331.13 | Professional | None | $131.83 | $239.88 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $3,235.94 Typical High $6,165.95 | Facility | None | $630.96 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $213.80 Typical High $354.81 | Professional | None | $109.65 | $213.80 | $354.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $316.23 Typical High $549.54 | Professional | 50 · Both sides | $162.18 | $316.23 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $436.52 | Facility | None | $138.04 | $138.04 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $426.58 Typical High $977.24 | Facility | None | $257.04 | $426.58 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $446.68 | Professional | None | $144.54 | $234.42 | $446.68 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $331.13 Median $537.03 Typical High $1,258.93 | Facility | None | $331.13 | $537.03 | $1,258.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $144.54 Median $275.42 Typical High $446.68 | Professional | None | $144.54 | $275.42 | $446.68 |
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 $131.83 Median $234.42 Typical High $416.87 | Professional | None | $131.83 | $234.42 | $416.87 |
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 $66.07 Median $120.23 Typical High $154.88 | Professional | 52 · Reduced service | $66.07 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $47.86 Typical High $61.66 | Professional | 53 · Discontinued | $26.30 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $177.83 Typical High $229.09 | Professional | 54 · Surgery only | $100.00 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $19.95 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $23.99 Typical High $30.90 | Professional | 56 · Pre-op care only | $13.18 | $23.99 | $30.90 |
Where Indiana sits
The same service costs 3.2 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· 37th of 51
$263
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.