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 $51.29 Median $138.04 Typical High $5,248.07 | Facility | None | $51.29 | $138.04 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $109.65 Typical High $154.88 | Professional | None | $52.48 | $109.65 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $144.54 | Facility | None | $75.86 | $75.86 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $104.71 Typical High $162.18 | Professional | None | $46.77 | $104.71 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $95.50 Typical High $218.78 | Professional | None | $51.29 | $95.50 | $218.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $117.49 Median $316.23 Typical High $2,187.76 | Facility | None | $117.49 | $316.23 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $56.23 Median $95.50 Typical High $181.97 | Professional | None | $56.23 | $95.50 | $181.97 |
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 $48.98 Median $112.20 Typical High $234.42 | Professional | None | $48.98 | $112.20 | $234.42 |
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 $26.92 Median $54.95 Typical High $72.44 | Professional | 52 · Reduced service | $26.92 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $21.88 Typical High $28.84 | Professional | 53 · Discontinued | $10.72 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $83.18 Typical High $107.15 | Professional | 54 · Surgery only | $39.81 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $16.60 Typical High $21.88 | Professional | 55 · Aftercare only | $8.13 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $10.96 Typical High $14.45 | Professional | 56 · Pre-op care only | $5.37 | $10.96 | $14.45 |
Where Indiana sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 44th of 51
$105
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.