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 $190.55 Median $1,047.13 Typical High $5,623.41 | Facility | None | $190.55 | $1,047.13 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $524.81 Typical High $812.83 | Professional | None | $181.97 | $524.81 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $204.17 | Professional | None | $128.82 | $128.82 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $446.68 Typical High $707.95 | Professional | None | $134.90 | $446.68 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $1,096.48 | Facility | None | $169.82 | $169.82 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $912.01 Typical High $1,318.26 | Facility | None | $602.56 | $912.01 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $891.25 | Professional | None | $169.82 | $302.00 | $891.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $436.52 Median $1,258.93 Typical High $2,238.72 | Facility | None | $436.52 | $1,258.93 | $2,238.72 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $177.83 Median $346.74 Typical High $1,230.27 | Professional | None | $177.83 | $346.74 | $1,230.27 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $162.18 Median $537.03 Typical High $1,071.52 | Professional | None | $162.18 | $537.03 | $1,071.52 |
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 $95.50 Median $288.40 Typical High $407.38 | Professional | 52 · Reduced service | $95.50 | $288.40 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $117.49 Typical High $162.18 | Professional | 53 · Discontinued | $38.02 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $436.52 Typical High $616.60 | Professional | 54 · Surgery only | $141.25 | $436.52 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $87.10 Typical High $123.03 | Professional | 55 · Aftercare only | $28.18 | $87.10 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $57.54 Typical High $81.28 | Professional | 56 · Pre-op care only | $19.05 | $57.54 | $81.28 |
Where Indiana sits
The same service costs 5.2 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· 40th of 51
$550
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.