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 $181.97 Median $3,467.37 Typical High $7,244.36 | Facility | None | $181.97 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $354.81 | Professional | None | $181.97 | $316.23 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $3,235.94 Typical High $6,165.95 | Facility | None | $630.96 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $524.81 | Professional | None | $208.93 | $331.13 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $660.69 | Facility | None | $199.53 | $199.53 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $512.86 Typical High $977.24 | Facility | None | $263.03 | $512.86 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $562.34 | Professional | None | $204.17 | $354.81 | $562.34 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $489.78 Median $891.25 Typical High $2,187.76 | Facility | None | $489.78 | $891.25 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $588.84 | Professional | None | $229.09 | $371.54 | $588.84 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $524.81 | Professional | None | $194.98 | $309.03 | $524.81 |
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 $91.20 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $91.20 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $63.10 Typical High $70.79 | Professional | 53 · Discontinued | $36.31 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $234.42 Typical High $263.03 | Professional | 54 · Surgery only | $134.90 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $46.77 Typical High $52.48 | Professional | 55 · Aftercare only | $26.92 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $31.62 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.20 | $31.62 | $35.48 |
Where Indiana sits
The same service costs 3.0 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· 35th of 51
$355
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.