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 $208.93 Typical High $5,011.87 | Facility | None | $39.81 | $208.93 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $138.04 Typical High $208.93 | Professional | None | $37.15 | $138.04 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $75.86 | Facility | None | $38.90 | $38.90 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $97.72 Typical High $158.49 | Professional | None | $33.11 | $97.72 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $74.13 Typical High $245.47 | Professional | None | $39.81 | $74.13 | $245.47 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $93.33 Median $478.63 Typical High $2,187.76 | Facility | None | $93.33 | $478.63 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $45.71 Median $81.28 Typical High $288.40 | Professional | None | $45.71 | $81.28 | $288.40 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $4,570.88 | Facility | None | $933.25 | $2,290.87 | $4,570.88 |
United Setting Professional Modifier None Typical Low $37.15 Median $109.65 Typical High $269.15 | Professional | None | $37.15 | $109.65 | $269.15 |
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 $18.62 Median $75.86 Typical High $91.20 | Professional | 52 · Reduced service | $18.62 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $30.20 Typical High $36.31 | Professional | 53 · Discontinued | $7.41 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $112.20 Typical High $134.90 | Professional | 54 · Surgery only | $27.54 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $22.91 Typical High $26.92 | Professional | 55 · Aftercare only | $5.50 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $15.14 Typical High $18.20 | Professional | 56 · Pre-op care only | $3.72 | $15.14 | $18.20 |
Where Indiana sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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· 47th of 51
$85.11
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.