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 $63.10 Median $1,380.38 Typical High $5,011.87 | Facility | None | $63.10 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $117.49 | Professional | None | $58.88 | $85.11 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $125.89 Typical High $1,071.52 | Facility | None | $72.44 | $125.89 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $83.18 Typical High $123.03 | Professional | None | $47.86 | $83.18 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $616.60 Typical High $912.01 | Facility | None | $53.70 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $2,691.53 | Facility | None | $602.56 | $2,290.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $100.00 Typical High $199.53 | Professional | None | $57.54 | $100.00 | $199.53 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $2,187.76 | Facility | None | $131.83 | $245.47 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $141.25 | Professional | None | $61.66 | $100.00 | $141.25 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $177.83 | Professional | None | $57.54 | $95.50 | $177.83 |
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 $29.51 Median $42.66 Typical High $50.12 | Professional | 52 · Reduced service | $29.51 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.98 Typical High $19.95 | Professional | 53 · Discontinued | $11.75 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $63.10 Typical High $75.86 | Professional | 54 · Surgery only | $43.65 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $8.71 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.51 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.89 | $8.51 | $10.00 |
Where Indiana sits
The same service costs 3.7 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· 47th of 51
$89.13
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.