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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | None | $67.61 | $67.61 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $1,905.46 Typical High $5,370.32 | Facility | None | $257.04 | $1,905.46 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.08 Median $8.32 Typical High $63.10 | Professional | None | $7.08 | $8.32 | $63.10 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $10.72 Median $12.59 Typical High $93.33 | Professional | 50 · Both sides | $10.72 | $12.59 | $93.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $4.47 Median $5.75 Typical High $36.31 | Professional | 62 · Two surgeons | $4.47 | $5.75 | $36.31 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $602.56 Typical High $1,659.59 | Facility | None | $363.08 | $602.56 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $120.23 | Professional | None | $72.44 | $87.10 | $120.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $194.98 Median $630.96 Typical High $2,089.30 | Facility | None | $194.98 | $630.96 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $141.25 | Professional | None | $72.44 | $93.33 | $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 $69.18 Median $87.10 Typical High $144.54 | Professional | None | $69.18 | $87.10 | $144.54 |
4 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 $33.88 Median $33.88 Typical High $36.31 | Professional | 52 · Reduced service | $33.88 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $14.79 | Professional | 53 · Discontinued | $13.49 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $10.96 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.24 |
Where Indiana sits
The same service costs 4.5 times more in Wisconsin than in Kentucky. 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· 45th of 51
$81.28
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.