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 $316.23 Median $2,137.96 Typical High $7,244.36 | Facility | None | $316.23 | $2,137.96 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $1,148.15 Typical High $1,479.11 | Professional | None | $316.23 | $1,148.15 | $1,479.11 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 50 · Both sides | $371.54 | $371.54 | $371.54 |
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 $281.84 Median $954.99 Typical High $1,698.24 | Professional | None | $281.84 | $954.99 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $1,380.38 Typical High $2,570.40 | Professional | 50 · Both sides | $416.87 | $1,380.38 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $549.54 Typical High $2,137.96 | Professional | None | $288.40 | $549.54 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $691.83 Median $954.99 Typical High $3,548.13 | Facility | None | $691.83 | $954.99 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $1,995.26 | Professional | None | $331.13 | $575.44 | $1,995.26 |
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 $288.40 Median $1,047.13 Typical High $2,187.76 | Professional | None | $288.40 | $1,047.13 | $2,187.76 |
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 $158.49 Median $575.44 Typical High $707.95 | Professional | 52 · Reduced service | $158.49 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $229.09 Typical High $288.40 | Professional | 53 · Discontinued | $63.10 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $851.14 Typical High $1,071.52 | Professional | 54 · Surgery only | $239.88 | $851.14 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $169.82 Typical High $213.80 | Professional | 55 · Aftercare only | $47.86 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $114.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $31.62 | $114.82 | $144.54 |
Where Indiana sits
The same service costs 5.1 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
$1,096
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.