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 $257.04 Median $3,467.37 Typical High $5,011.87 | Facility | None | $257.04 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $316.23 | Professional | None | $234.42 | $257.04 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $467.74 | Professional | None | $194.98 | $346.74 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
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 $229.09 Median $338.84 Typical High $478.63 | Professional | None | $229.09 | $338.84 | $478.63 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $489.78 Median $616.60 Typical High $2,187.76 | Facility | None | $489.78 | $616.60 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $380.19 | Professional | None | $239.88 | $281.84 | $380.19 |
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 $229.09 Median $331.13 Typical High $467.74 | Professional | None | $229.09 | $331.13 | $467.74 |
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 $117.49 Median $128.82 Typical High $144.54 | Professional | 52 · Reduced service | $117.49 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $51.29 Typical High $57.54 | Professional | 53 · Discontinued | $46.77 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $194.98 Typical High $213.80 | Professional | 54 · Surgery only | $177.83 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $43.65 | Professional | 55 · Aftercare only | $35.48 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.70 Typical High $28.84 | Professional | 56 · Pre-op care only | $23.44 | $25.70 | $28.84 |
Where Indiana sits
The same service costs 4.0 times more in Wisconsin than in New York. 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· 36th of 51
$355
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.