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 $91.20 Median $537.03 Typical High $5,623.41 | Facility | None | $91.20 | $537.03 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $165.96 | Professional | None | $87.10 | $120.23 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $158.49 Typical High $190.55 | Professional | None | $56.23 | $158.49 | $190.55 |
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 $74.13 Median $123.03 Typical High $173.78 | Professional | None | $74.13 | $123.03 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $144.54 | Facility | None | $93.33 | $93.33 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $794.33 | Facility | None | $91.20 | $151.36 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $208.93 | Professional | None | $95.50 | $134.90 | $208.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $134.90 Median $239.88 Typical High $1,000.00 | Facility | None | $134.90 | $239.88 | $1,000.00 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $223.87 | Professional | None | $91.20 | $147.91 | $223.87 |
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 $89.13 Median $128.82 Typical High $204.17 | Professional | None | $89.13 | $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 $43.65 Median $57.54 Typical High $64.57 | Professional | 52 · Reduced service | $43.65 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.91 Typical High $26.30 | Professional | 53 · Discontinued | $17.38 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $85.11 Typical High $97.72 | Professional | 54 · Surgery only | $66.07 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.98 Typical High $19.50 | Professional | 55 · Aftercare only | $13.18 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.48 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.71 | $11.48 | $12.88 |
Where Indiana sits
The same service costs 3.3 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· 41st of 51
$132
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.