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 $10.72 Median $10.72 Typical High $35.48 | Facility | None | $10.72 | $10.72 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $22.39 Typical High $38.90 | Professional | None | $10.00 | $22.39 | $38.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.85 Median $602.56 Typical High $1,071.52 | Facility | None | $15.85 | $602.56 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.76 Median $21.88 Typical High $50.12 | Professional | None | $7.76 | $21.88 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $9.33 Median $616.60 Typical High $912.01 | Facility | None | $9.33 | $616.60 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $28.18 Median $32.36 Typical High $38.90 | Professional | None | $28.18 | $32.36 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,290.87 Typical High $2,691.53 | Facility | None | $524.81 | $2,290.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $28.18 Typical High $56.23 | Professional | None | $9.55 | $28.18 | $56.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $22.91 Median $912.01 Typical High $2,187.76 | Facility | None | $22.91 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $10.96 Median $18.20 Typical High $47.86 | Professional | None | $10.96 | $18.20 | $47.86 |
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 $9.55 Median $22.39 Typical High $47.86 | Professional | None | $9.55 | $22.39 | $47.86 |
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 $5.01 Median $13.80 Typical High $17.38 | Professional | 52 · Reduced service | $5.01 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $5.50 Typical High $7.08 | Professional | 53 · Discontinued | $2.00 | $5.50 | $7.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.59 Median $20.42 Typical High $26.30 | Professional | 54 · Surgery only | $7.59 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $4.07 Typical High $5.25 | Professional | 55 · Aftercare only | $1.51 | $4.07 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $2.75 Typical High $3.55 | Professional | 56 · Pre-op care only | $1.00 | $2.75 | $3.55 |
Where Indiana sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 40th of 51
$28.18
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.