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 $66.07 Median $3,801.89 Typical High $5,623.41 | Facility | None | $66.07 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $128.82 Typical High $162.18 | Professional | None | $66.07 | $128.82 | $162.18 |
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 $75.86 Median $151.36 Typical High $251.19 | Professional | None | $75.86 | $151.36 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $218.78 | Facility | None | $72.44 | $72.44 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $234.42 Typical High $954.99 | Facility | None | $138.04 | $234.42 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $128.82 Typical High $251.19 | Professional | None | $74.13 | $128.82 | $251.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $181.97 Median $275.42 Typical High $954.99 | Facility | None | $181.97 | $275.42 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $288.40 | Professional | None | $85.11 | $144.54 | $288.40 |
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 $72.44 Median $123.03 Typical High $229.09 | Professional | None | $72.44 | $123.03 | $229.09 |
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 $33.11 Median $66.07 Typical High $81.28 | Professional | 52 · Reduced service | $33.11 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $26.30 Typical High $32.36 | Professional | 53 · Discontinued | $13.49 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $100.00 Typical High $123.03 | Professional | 54 · Surgery only | $50.12 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $19.95 Typical High $24.55 | Professional | 55 · Aftercare only | $10.00 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $13.18 Typical High $16.22 | Professional | 56 · Pre-op care only | $6.61 | $13.18 | $16.22 |
Where Indiana sits
The same service costs 3.6 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· 28th of 51
$151
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.