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 $83.18 Median $3,801.89 Typical High $5,623.41 | Facility | None | $83.18 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $794.33 Typical High $954.99 | Professional | None | $83.18 | $794.33 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,248.07 Typical High $9,549.93 | Facility | None | $630.96 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $870.96 | Professional | None | $57.54 | $97.72 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $1,318.26 | Facility | None | $87.10 | $87.10 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,000.00 Typical High $1,659.59 | Facility | None | $446.68 | $1,000.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $123.03 Typical High $1,348.96 | Professional | None | $44.67 | $123.03 | $1,348.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $234.42 Median $1,513.56 Typical High $2,884.03 | Facility | None | $234.42 | $1,513.56 | $2,884.03 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $104.71 Median $354.81 Typical High $1,513.56 | Professional | None | $104.71 | $354.81 | $1,513.56 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $75.86 Median $588.84 Typical High $1,202.26 | Professional | None | $75.86 | $588.84 | $1,202.26 |
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 $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $41.69 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $158.49 Typical High $190.55 | Professional | 53 · Discontinued | $16.60 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $61.66 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $120.23 Typical High $141.25 | Professional | 55 · Aftercare only | $12.30 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $79.43 Typical High $95.50 | Professional | 56 · Pre-op care only | $8.32 | $79.43 | $95.50 |
Where Indiana sits
The same service costs 14.1 times more in Washington 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· 44th of 51
$234
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.