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 $85.11 Median $3,801.89 Typical High $5,623.41 | Facility | None | $85.11 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $295.12 Typical High $346.74 | Professional | None | $85.11 | $295.12 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $204.17 Typical High $346.74 | Professional | None | $67.61 | $204.17 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $269.15 | Facility | None | $89.13 | $89.13 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $275.42 Typical High $1,412.54 | Facility | None | $165.96 | $275.42 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $229.09 Typical High $478.63 | Professional | None | $87.10 | $229.09 | $478.63 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $239.88 Median $295.12 Typical High $1,047.13 | Facility | None | $239.88 | $295.12 | $1,047.13 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $537.03 | Professional | None | $95.50 | $141.25 | $537.03 |
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 $79.43 Median $263.03 Typical High $478.63 | Professional | None | $79.43 | $263.03 | $478.63 |
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 $41.69 Median $147.91 Typical High $169.82 | Professional | 52 · Reduced service | $41.69 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $16.98 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $63.10 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $44.67 Typical High $50.12 | Professional | 55 · Aftercare only | $12.59 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $29.51 Typical High $33.88 | Professional | 56 · Pre-op care only | $8.51 | $29.51 | $33.88 |
Where Indiana sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 35th of 51
$251
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.