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 $407.38 Median $5,011.87 Typical High $7,244.36 | Facility | None | $407.38 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $1,819.70 Typical High $2,454.71 | Professional | None | $407.38 | $1,819.70 | $2,454.71 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $16,595.87 Typical High $25,703.96 | Facility | None | $7,244.36 | $16,595.87 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $1,479.11 Typical High $2,818.38 | Professional | None | $371.54 | $1,479.11 | $2,818.38 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $562.34 Typical High $645.65 | Facility | None | $363.08 | $562.34 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $691.83 Typical High $3,311.31 | Professional | None | $371.54 | $691.83 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $870.96 Median $954.99 Typical High $5,370.32 | Facility | None | $870.96 | $954.99 | $5,370.32 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $416.87 Median $794.33 Typical High $3,090.30 | Professional | None | $416.87 | $794.33 | $3,090.30 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $11,481.54 Typical High $15,135.61 | Facility | None | $5,128.61 | $11,481.54 | $15,135.61 |
United Setting Professional Modifier None Typical Low $371.54 Median $1,819.70 Typical High $3,630.78 | Professional | None | $371.54 | $1,819.70 | $3,630.78 |
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 $204.17 Median $912.01 Typical High $1,230.27 | Professional | 52 · Reduced service | $204.17 | $912.01 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $363.08 Typical High $489.78 | Professional | 53 · Discontinued | $81.28 | $363.08 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $1,380.38 Typical High $1,819.70 | Professional | 54 · Surgery only | $302.00 | $1,380.38 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $275.42 Typical High $363.08 | Professional | 55 · Aftercare only | $60.26 | $275.42 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $181.97 Typical High $245.47 | Professional | 56 · Pre-op care only | $40.74 | $181.97 | $245.47 |
Where Indiana sits
The same service costs 6.9 times more in Wisconsin than in Hawaii. 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· 35th of 51
$1,778
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.