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 $34.67 Median $123.03 Typical High $5,011.87 | Facility | None | $34.67 | $123.03 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $91.20 Typical High $114.82 | Professional | None | $28.18 | $91.20 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $3,235.94 Typical High $6,309.57 | Facility | None | $724.44 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $56.23 Typical High $104.71 | Professional | None | $24.55 | $56.23 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $177.83 | Facility | None | $30.20 | $30.20 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $141.25 Typical High $269.15 | Facility | None | $66.07 | $141.25 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $60.26 Typical High $144.54 | Professional | None | $33.88 | $60.26 | $144.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $85.11 Median $229.09 Typical High $1,659.59 | Facility | None | $85.11 | $229.09 | $1,659.59 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $37.15 Median $60.26 Typical High $165.96 | Professional | None | $37.15 | $60.26 | $165.96 |
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 $30.90 Median $79.43 Typical High $165.96 | Professional | None | $30.90 | $79.43 | $165.96 |
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 $14.13 Median $45.71 Typical High $48.98 | Professional | 52 · Reduced service | $14.13 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $18.20 Typical High $19.50 | Professional | 53 · Discontinued | $5.62 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $67.61 Typical High $74.13 | Professional | 54 · Surgery only | $21.38 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $13.80 Typical High $14.79 | Professional | 55 · Aftercare only | $4.27 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $9.12 Typical High $9.77 | Professional | 56 · Pre-op care only | $2.82 | $9.12 | $9.77 |
Where Indiana sits
The same service costs 5.4 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· 44th 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.