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 $162.18 Typical High $5,623.41 | Facility | None | $66.07 | $162.18 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $120.23 | Professional | None | $63.10 | $89.13 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $89.13 | Professional | None | $69.18 | $69.18 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $6,165.95 | Facility | None | $616.60 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $131.83 | Professional | None | $53.70 | $89.13 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $114.82 | Facility | None | $67.61 | $67.61 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $117.49 Typical High $794.33 | Facility | None | $70.79 | $117.49 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $162.18 | Professional | None | $72.44 | $100.00 | $162.18 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $107.15 Median $173.78 Typical High $2,089.30 | Facility | None | $107.15 | $173.78 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $169.82 | Professional | None | $66.07 | $112.20 | $169.82 |
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 $64.57 Median $95.50 Typical High $154.88 | Professional | None | $64.57 | $95.50 | $154.88 |
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 $31.62 Median $43.65 Typical High $51.29 | Professional | 52 · Reduced service | $31.62 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $17.38 Typical High $20.42 | Professional | 53 · Discontinued | $12.88 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $66.07 Typical High $75.86 | Professional | 54 · Surgery only | $47.86 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $13.18 Typical High $15.14 | Professional | 55 · Aftercare only | $9.55 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.71 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.31 | $8.71 | $10.23 |
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· 38th of 51
$100
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.