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 $75.86 Median $208.93 Typical High $5,011.87 | Facility | None | $75.86 | $208.93 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $218.78 | Professional | None | $79.43 | $165.96 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | None | $53.70 | $53.70 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $275.42 | Facility | None | $144.54 | $144.54 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $407.38 | Professional | None | $114.82 | $165.96 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $288.40 | Professional | None | $74.13 | $138.04 | $288.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $173.78 Median $478.63 Typical High $2,187.76 | Facility | None | $173.78 | $478.63 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $74.13 Median $144.54 Typical High $309.03 | Professional | None | $74.13 | $144.54 | $309.03 |
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 $70.79 Median $165.96 Typical High $331.13 | Professional | None | $70.79 | $165.96 | $331.13 |
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 $39.81 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $39.81 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $15.85 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $123.03 Typical High $151.36 | Professional | 54 · Surgery only | $60.26 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $12.02 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $7.94 | $16.60 | $19.95 |
Where Indiana sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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
$162
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.