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 $831.76 Median $3,467.37 Typical High $5,011.87 | Facility | None | $831.76 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $5,011.87 | Professional | None | $831.76 | $831.76 | $5,011.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $10,715.19 Typical High $28,840.32 | Facility | None | $1,778.28 | $10,715.19 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,445.44 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,905.46 | $1,905.46 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,290.87 | Facility | None | $912.01 | $954.99 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $416.87 Median $416.87 Typical High $2,454.71 | Professional | 52 · Reduced service | $416.87 | $416.87 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $1,000.00 | Professional | 53 · Discontinued | $165.96 | $165.96 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $3,715.35 | Professional | 54 · Surgery only | $616.60 | $616.60 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $741.31 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $501.19 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $501.19 |
Where Indiana sits
The same service costs 190.5 times more in Wisconsin than in Hawaii. 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· 15th of 51
$1,445
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.