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 $141.25 Median $5,011.87 Typical High $7,244.36 | Facility | None | $141.25 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $512.86 Typical High $645.65 | Professional | None | $138.04 | $512.86 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $407.38 | Facility | None | $208.93 | $208.93 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $331.13 Typical High $537.03 | Professional | None | $125.89 | $331.13 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $251.19 Typical High $831.76 | Professional | None | $128.82 | $251.19 | $831.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $302.00 Median $954.99 Typical High $2,187.76 | Facility | None | $302.00 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $870.96 | Professional | None | $144.54 | $245.47 | $870.96 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $4,570.88 | Facility | None | $933.25 | $2,290.87 | $4,570.88 |
United Setting Professional Modifier None Typical Low $125.89 Median $338.84 Typical High $891.25 | Professional | None | $125.89 | $338.84 | $891.25 |
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 $69.18 Median $257.04 Typical High $323.59 | Professional | 52 · Reduced service | $69.18 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $102.33 Typical High $128.82 | Professional | 53 · Discontinued | $27.54 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $380.19 Typical High $489.78 | Professional | 54 · Surgery only | $102.33 | $380.19 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $75.86 Typical High $97.72 | Professional | 55 · Aftercare only | $20.89 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $51.29 Typical High $64.57 | Professional | 56 · Pre-op care only | $13.80 | $51.29 | $64.57 |
Where Indiana sits
The same service costs 4.0 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· 46th of 51
$324
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.