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 $58.88 Median $1,380.38 Typical High $5,623.41 | Facility | None | $58.88 | $1,380.38 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $83.18 Typical High $97.72 | Professional | None | $58.88 | $83.18 | $97.72 |
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 $64.57 Median $102.33 Typical High $165.96 | Professional | None | $64.57 | $102.33 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $87.10 | Facility | None | $66.07 | $66.07 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $93.33 Typical High $794.33 | Facility | None | $56.23 | $93.33 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $173.78 | Professional | None | $66.07 | $91.20 | $173.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $81.28 Median $169.82 Typical High $954.99 | Facility | None | $81.28 | $169.82 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $158.49 | Professional | None | $74.13 | $114.82 | $158.49 |
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 $63.10 Median $93.33 Typical High $141.25 | Professional | None | $63.10 | $93.33 | $141.25 |
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 $29.51 Median $41.69 Typical High $44.67 | Professional | 52 · Reduced service | $29.51 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.60 Typical High $18.20 | Professional | 53 · Discontinued | $12.02 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $61.66 Typical High $67.61 | Professional | 54 · Surgery only | $44.67 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.30 Typical High $13.49 | Professional | 55 · Aftercare only | $8.91 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.32 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.89 | $8.32 | $9.12 |
Where Indiana sits
The same service costs 3.5 times more in Wisconsin than in Florida. 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· 32nd of 51
$102
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.