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 $38.02 Median $1,380.38 Typical High $5,011.87 | Facility | None | $38.02 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $69.18 Typical High $74.13 | Professional | None | $38.02 | $69.18 | $74.13 |
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 $72.44 Typical High $138.04 | Professional | None | $42.66 | $72.44 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $40.74 Median $616.60 Typical High $912.01 | Facility | None | $40.74 | $616.60 | $912.01 |
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 $41.69 Median $72.44 Typical High $147.91 | Professional | None | $41.69 | $72.44 | $147.91 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $102.33 Median $218.78 Typical High $2,089.30 | Facility | None | $102.33 | $218.78 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $47.86 Median $81.28 Typical High $134.90 | Professional | None | $47.86 | $81.28 | $134.90 |
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 $39.81 Median $67.61 Typical High $117.49 | Professional | None | $39.81 | $67.61 | $117.49 |
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 $19.05 Median $34.67 Typical High $37.15 | Professional | 52 · Reduced service | $19.05 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $13.80 Typical High $14.79 | Professional | 53 · Discontinued | $7.59 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $52.48 Typical High $56.23 | Professional | 54 · Surgery only | $28.18 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $10.47 Typical High $11.22 | Professional | 55 · Aftercare only | $5.62 | $10.47 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.92 Typical High $7.41 | Professional | 56 · Pre-op care only | $3.80 | $6.92 | $7.41 |
Where Indiana sits
The same service costs 3.4 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· 33rd of 51
$77.62
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.