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 $89.13 Median $1,380.38 Typical High $5,011.87 | Facility | None | $89.13 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $141.25 | Professional | None | $89.13 | $114.82 | $141.25 |
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 $72.44 Median $104.71 Typical High $154.88 | Professional | None | $72.44 | $104.71 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $691.83 | Facility | None | $93.33 | $93.33 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $1,023.29 | Facility | None | $398.11 | $562.34 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $204.17 | Professional | None | $97.72 | $147.91 | $204.17 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $245.47 Median $776.25 Typical High $1,995.26 | Facility | None | $245.47 | $776.25 | $1,995.26 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $223.87 | Professional | None | $97.72 | $147.91 | $223.87 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $213.80 | Professional | None | $93.33 | $138.04 | $213.80 |
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 $44.67 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $44.67 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.91 Typical High $28.18 | Professional | 53 · Discontinued | $18.20 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $85.11 Typical High $104.71 | Professional | 54 · Surgery only | $67.61 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.98 Typical High $20.89 | Professional | 55 · Aftercare only | $13.49 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.48 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.91 | $11.48 | $14.13 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Indiana. 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· 51st 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.