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 $147.91 Median $691.83 Typical High $5,011.87 | Facility | None | $147.91 | $691.83 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $537.03 Typical High $724.44 | Professional | None | $151.36 | $537.03 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $467.74 | Facility | None | $239.88 | $239.88 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $371.54 Typical High $602.56 | Professional | None | $128.82 | $371.54 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $562.34 Typical High $954.99 | Professional | 50 · Both sides | $190.55 | $562.34 | $954.99 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $269.15 Typical High $977.24 | Professional | None | $141.25 | $269.15 | $977.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $338.84 Median $954.99 Typical High $2,187.76 | Facility | None | $338.84 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $912.01 | Professional | None | $162.18 | $275.42 | $912.01 |
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 $144.54 Median $398.11 Typical High $1,000.00 | Professional | None | $144.54 | $398.11 | $1,000.00 |
6 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 $77.62 Median $269.15 Typical High $346.74 | Professional | 52 · Reduced service | $77.62 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $107.15 Typical High $138.04 | Professional | 53 · Discontinued | $30.90 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $398.11 Typical High $512.86 | Professional | 54 · Surgery only | $114.82 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $79.43 Typical High $104.71 | Professional | 55 · Aftercare only | $23.44 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $53.70 Typical High $69.18 | Professional | 56 · Pre-op care only | $15.49 | $53.70 | $69.18 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 51 · Multiple procedures | $60.26 | $60.26 | $60.26 |
Where Indiana sits
The same service costs 3.8 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· 46th of 51
$372
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.