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 $213.80 Median $1,148.15 Typical High $7,244.36 | Facility | None | $213.80 | $1,148.15 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $891.25 Typical High $1,202.26 | Professional | None | $223.87 | $891.25 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $12,022.64 Typical High $18,197.01 | Facility | None | $4,786.30 | $12,022.64 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $741.31 Typical High $1,380.38 | Professional | None | $204.17 | $741.31 | $1,380.38 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $416.87 Typical High $1,737.80 | Professional | None | $204.17 | $416.87 | $1,737.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $489.78 Median $954.99 Typical High $2,691.53 | Facility | None | $489.78 | $954.99 | $2,691.53 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $1,513.56 | Professional | None | $234.42 | $398.11 | $1,513.56 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $8,317.64 Typical High $10,715.19 | Facility | None | $4,073.80 | $8,317.64 | $10,715.19 |
United Setting Professional Modifier None Typical Low $204.17 Median $870.96 Typical High $1,778.28 | Professional | None | $204.17 | $870.96 | $1,778.28 |
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 $112.20 Median $446.68 Typical High $588.84 | Professional | 52 · Reduced service | $112.20 | $446.68 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $177.83 Typical High $234.42 | Professional | 53 · Discontinued | $44.67 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $676.08 Typical High $891.25 | Professional | 54 · Surgery only | $165.96 | $676.08 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $134.90 Typical High $177.83 | Professional | 55 · Aftercare only | $33.11 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $89.13 Typical High $117.49 | Professional | 56 · Pre-op care only | $22.39 | $89.13 | $117.49 |
Where Indiana sits
The same service costs 5.9 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· 37th of 51
$871
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.