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 $436.52 Median $3,890.45 Typical High $5,248.07 | Facility | None | $436.52 | $3,890.45 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $1,380.38 Typical High $2,290.87 | Professional | None | $354.81 | $1,380.38 | $2,290.87 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $501.19 | Professional | None | $363.08 | $501.19 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $1,148.15 Typical High $2,691.53 | Professional | None | $309.03 | $1,148.15 | $2,691.53 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $2,754.23 | Facility | None | $389.05 | $389.05 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,630.27 Typical High $5,128.61 | Facility | None | $645.65 | $2,630.27 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,479.11 Typical High $2,511.89 | Professional | None | $389.05 | $1,479.11 | $2,511.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,047.13 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,047.13 | $3,162.28 | $9,549.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $4,570.88 | Professional | None | $426.58 | $691.83 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $389.05 Median $1,380.38 Typical High $3,019.95 | Professional | None | $389.05 | $1,380.38 | $3,019.95 |
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 $177.83 Median $741.31 Typical High $831.76 | Professional | 52 · Reduced service | $177.83 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $295.12 Typical High $331.13 | Professional | 53 · Discontinued | $70.79 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $1,096.48 Typical High $1,230.27 | Professional | 54 · Surgery only | $269.15 | $1,096.48 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $218.78 Typical High $245.47 | Professional | 55 · Aftercare only | $53.70 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $147.91 Typical High $165.96 | Professional | 56 · Pre-op care only | $35.48 | $147.91 | $165.96 |
Where Indiana sits
The same service costs 3.6 times more in Iowa than in Nebraska. 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· 41st of 51
$1,479
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.