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 $26.92 Median $54.95 Typical High $5,011.87 | Facility | None | $26.92 | $54.95 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $41.69 Typical High $60.26 | Professional | None | $23.44 | $41.69 | $60.26 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $48.98 Typical High $53.70 | Professional | None | $39.81 | $48.98 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,090.30 Typical High $6,165.95 | Facility | None | $616.60 | $3,090.30 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $38.02 Typical High $125.89 | Professional | None | $20.89 | $38.02 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $25.70 Median $616.60 Typical High $912.01 | Facility | None | $25.70 | $616.60 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $39.81 Median $45.71 Typical High $56.23 | Professional | None | $39.81 | $45.71 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $51.29 Typical High $147.91 | Professional | None | $26.30 | $51.29 | $147.91 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $63.10 Median $186.21 Typical High $2,089.30 | Facility | None | $63.10 | $186.21 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $28.84 Median $51.29 Typical High $79.43 | Professional | None | $28.84 | $51.29 | $79.43 |
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 $26.30 Median $45.71 Typical High $83.18 | Professional | None | $26.30 | $45.71 | $83.18 |
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 $11.75 Median $20.89 Typical High $22.39 | Professional | 52 · Reduced service | $11.75 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $8.32 Typical High $8.91 | Professional | 53 · Discontinued | $4.68 | $8.32 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $30.90 Typical High $33.88 | Professional | 54 · Surgery only | $17.78 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $6.17 Typical High $6.76 | Professional | 55 · Aftercare only | $3.55 | $6.17 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $4.17 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.34 | $4.17 | $4.47 |
Where Indiana sits
The same service costs 3.4 times more in Wisconsin than in Utah. 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
$48.98
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.