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 $32.36 Median $95.50 Typical High $5,011.87 | Facility | None | $32.36 | $95.50 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $70.79 Typical High $100.00 | Professional | None | $28.18 | $70.79 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $97.72 | Professional | None | $58.88 | $69.18 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $3,162.28 Typical High $6,309.57 | Facility | None | $549.54 | $3,162.28 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $61.66 Typical High $151.36 | Professional | None | $25.12 | $61.66 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $107.15 | Facility | None | $30.90 | $30.90 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $93.33 | Professional | None | $67.61 | $77.62 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $87.10 Typical High $147.91 | Facility | None | $58.88 | $87.10 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $81.28 Typical High $177.83 | Professional | None | $35.48 | $81.28 | $177.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $77.62 Median $144.54 Typical High $954.99 | Facility | None | $77.62 | $144.54 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $34.67 Median $75.86 Typical High $134.90 | Professional | None | $34.67 | $75.86 | $134.90 |
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 $33.88 Median $70.79 Typical High $125.89 | Professional | None | $33.88 | $70.79 | $125.89 |
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 $35.48 Typical High $38.02 | Professional | 52 · Reduced service | $14.13 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $14.13 Typical High $15.14 | Professional | 53 · Discontinued | $5.62 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $53.70 Typical High $57.54 | Professional | 54 · Surgery only | $20.89 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $10.72 Typical High $11.48 | Professional | 55 · Aftercare only | $4.27 | $10.72 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $7.08 Typical High $7.59 | Professional | 56 · Pre-op care only | $2.82 | $7.08 | $7.59 |
Where Indiana sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 45th of 51
$75.86
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.