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 $39.81 Median $3,801.89 Typical High $5,623.41 | Facility | None | $39.81 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $117.49 Typical High $162.18 | Professional | None | $39.81 | $117.49 | $162.18 |
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 $28.18 Median $69.18 Typical High $134.90 | Professional | None | $28.18 | $69.18 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $40.74 Median $831.76 Typical High $1,230.27 | Facility | None | $40.74 | $831.76 | $1,230.27 |
CareSource Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $58.88 Typical High $316.23 | Facility | None | $40.74 | $58.88 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $64.57 Typical High $223.87 | Professional | None | $38.02 | $64.57 | $223.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $109.65 Median $912.01 Typical High $2,187.76 | Facility | None | $109.65 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $48.98 Median $89.13 Typical High $263.03 | Professional | None | $48.98 | $89.13 | $263.03 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $37.15 Median $93.33 Typical High $190.55 | Professional | None | $37.15 | $93.33 | $190.55 |
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 $19.95 Median $58.88 Typical High $81.28 | Professional | 52 · Reduced service | $19.95 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $23.44 Typical High $32.36 | Professional | 53 · Discontinued | $7.94 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $89.13 Typical High $120.23 | Professional | 54 · Surgery only | $29.51 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $17.78 Typical High $24.55 | Professional | 55 · Aftercare only | $5.89 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $11.75 Typical High $16.22 | Professional | 56 · Pre-op care only | $3.98 | $11.75 | $16.22 |
Where Indiana sits
The same service costs 4.6 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· 46th of 51
$83.18
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.