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 $162.18 Median $331.13 Typical High $7,244.36 | Facility | None | $162.18 | $331.13 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $239.88 | Professional | None | $117.49 | $186.21 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $165.96 Typical High $165.96 | Professional | None | $72.44 | $165.96 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $3,235.94 Typical High $6,165.95 | Facility | None | $724.44 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $177.83 Typical High $323.59 | Professional | None | $97.72 | $177.83 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $251.19 | Facility | None | $123.03 | $123.03 | $251.19 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $245.47 | Professional | None | $173.78 | $204.17 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $251.19 Typical High $794.33 | Facility | None | $151.36 | $251.19 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $416.87 | Professional | None | $138.04 | $229.09 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $323.59 Typical High $1,258.93 | Facility | None | $229.09 | $323.59 | $1,258.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $331.13 | Professional | None | $128.82 | $213.80 | $331.13 |
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 $125.89 Median $199.53 Typical High $316.23 | Professional | None | $125.89 | $199.53 | $316.23 |
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 $58.88 Median $87.10 Typical High $109.65 | Professional | 52 · Reduced service | $58.88 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $44.67 | Professional | 53 · Discontinued | $23.44 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $131.83 Typical High $165.96 | Professional | 54 · Surgery only | $87.10 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.30 Typical High $33.11 | Professional | 55 · Aftercare only | $17.78 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $11.75 | $17.38 | $22.39 |
Where Indiana sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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· 39th of 51
$204
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.