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 $83.18 Median $1,380.38 Typical High $5,011.87 | Facility | None | $83.18 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $134.90 | Professional | None | $83.18 | $114.82 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
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 $69.18 Median $117.49 Typical High $194.98 | Professional | None | $69.18 | $117.49 | $194.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $177.83 Typical High $295.12 | Professional | 50 · Both sides | $104.71 | $177.83 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $134.90 | Facility | None | $87.10 | $87.10 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $114.82 Typical High $194.98 | Facility | None | $66.07 | $114.82 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $218.78 | Professional | None | $83.18 | $125.89 | $218.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $120.23 Median $229.09 Typical High $2,089.30 | Facility | None | $120.23 | $229.09 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $213.80 | Professional | None | $87.10 | $141.25 | $213.80 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $204.17 | Professional | None | $85.11 | $128.82 | $204.17 |
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 $41.69 Median $56.23 Typical High $67.61 | Professional | 52 · Reduced service | $41.69 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $22.39 Typical High $26.92 | Professional | 53 · Discontinued | $16.60 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $85.11 Typical High $100.00 | Professional | 54 · Surgery only | $61.66 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.98 Typical High $19.95 | Professional | 55 · Aftercare only | $12.30 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.22 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.32 | $11.22 | $13.49 |
Where Indiana sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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· 36th of 51
$129
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.