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 $346.74 Median $2,187.76 Typical High $5,248.07 | Facility | None | $346.74 | $2,187.76 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $1,380.38 Typical High $1,862.09 | Professional | None | $354.81 | $1,380.38 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $295.12 Typical High $407.38 | Professional | None | $144.54 | $295.12 | $407.38 |
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 $302.00 Median $1,174.90 Typical High $1,862.09 | Professional | None | $302.00 | $1,174.90 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $1,778.28 Typical High $2,754.23 | Professional | 50 · Both sides | $457.09 | $1,778.28 | $2,754.23 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $630.96 Typical High $2,454.71 | Professional | None | $316.23 | $630.96 | $2,454.71 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $5,011.87 | Facility | None | $794.33 | $954.99 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $380.19 Median $758.58 Typical High $2,570.40 | Professional | None | $380.19 | $758.58 | $2,570.40 |
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 $323.59 Median $1,288.25 Typical High $2,570.40 | Professional | None | $323.59 | $1,288.25 | $2,570.40 |
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 $177.83 Median $741.31 Typical High $912.01 | Professional | 52 · Reduced service | $177.83 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $295.12 Typical High $363.08 | Professional | 53 · Discontinued | $70.79 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $1,096.48 Typical High $1,348.96 | Professional | 54 · Surgery only | $269.15 | $1,096.48 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $218.78 Typical High $269.15 | Professional | 55 · Aftercare only | $53.70 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $147.91 Typical High $181.97 | Professional | 56 · Pre-op care only | $35.48 | $147.91 | $181.97 |
Where Indiana sits
The same service costs 5.6 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· 36th of 51
$1,380
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.