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 $44.67 Median $1,380.38 Typical High $5,011.87 | Facility | None | $44.67 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $91.20 | Professional | None | $44.67 | $66.07 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $83.18 | Professional | None | $50.12 | $61.66 | $83.18 |
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 $38.02 Median $64.57 Typical High $109.65 | Professional | None | $38.02 | $64.57 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $79.43 | Facility | None | $47.86 | $47.86 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $64.57 Typical High $95.50 | Facility | None | $42.66 | $64.57 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $134.90 | Professional | None | $52.48 | $77.62 | $134.90 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $72.44 Median $123.03 Typical High $954.99 | Facility | None | $72.44 | $123.03 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $123.03 | Professional | None | $46.77 | $77.62 | $123.03 |
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 $45.71 Median $74.13 Typical High $117.49 | Professional | None | $45.71 | $74.13 | $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 $22.39 Median $31.62 Typical High $36.31 | Professional | 52 · Reduced service | $22.39 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $12.59 Typical High $14.79 | Professional | 53 · Discontinued | $8.91 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $47.86 Typical High $54.95 | Professional | 54 · Surgery only | $33.88 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $9.55 Typical High $10.96 | Professional | 55 · Aftercare only | $6.76 | $9.55 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.31 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.47 | $6.31 | $7.41 |
Where Indiana sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 39th of 51
$74.13
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.