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 $47.86 Median $177.83 Typical High $5,623.41 | Facility | None | $47.86 | $177.83 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $91.20 Typical High $123.03 | Professional | None | $47.86 | $91.20 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | None | $87.10 | $87.10 | $104.71 |
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 $42.66 Median $79.43 Typical High $199.53 | Professional | None | $42.66 | $79.43 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $128.82 | Facility | None | $53.70 | $53.70 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $134.90 Typical High $794.33 | Facility | None | $81.28 | $134.90 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $234.42 | Professional | None | $57.54 | $97.72 | $234.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $120.23 Median $173.78 Typical High $954.99 | Facility | None | $120.23 | $173.78 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $61.66 Median $104.71 Typical High $173.78 | Professional | None | $61.66 | $104.71 | $173.78 |
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 $53.70 Median $91.20 Typical High $162.18 | Professional | None | $53.70 | $91.20 | $162.18 |
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 $23.99 Median $45.71 Typical High $48.98 | Professional | 52 · Reduced service | $23.99 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $18.20 Typical High $19.50 | Professional | 53 · Discontinued | $9.55 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $67.61 Typical High $72.44 | Professional | 54 · Surgery only | $36.31 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $13.49 Typical High $14.45 | Professional | 55 · Aftercare only | $7.24 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $9.12 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.79 | $9.12 | $9.77 |
Where Indiana sits
The same service costs 2.8 times more in Wisconsin 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· 43rd of 51
$97.72
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.