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 $117.49 Median $3,801.89 Typical High $5,623.41 | Facility | None | $117.49 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $208.93 | Professional | None | $117.49 | $154.88 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $251.19 | Professional | None | $218.78 | $251.19 | $251.19 |
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 $100.00 Median $162.18 Typical High $239.88 | Professional | None | $100.00 | $162.18 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $186.21 | Facility | None | $125.89 | $125.89 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $190.55 Typical High $794.33 | Facility | None | $114.82 | $190.55 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $288.40 | Professional | None | $125.89 | $181.97 | $288.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $173.78 Median $316.23 Typical High $2,089.30 | Facility | None | $173.78 | $316.23 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $295.12 | Professional | None | $123.03 | $199.53 | $295.12 |
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 $120.23 Median $173.78 Typical High $275.42 | Professional | None | $120.23 | $173.78 | $275.42 |
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 $58.88 Median $75.86 Typical High $87.10 | Professional | 52 · Reduced service | $58.88 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $30.90 Typical High $34.67 | Professional | 53 · Discontinued | $23.44 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $114.82 Typical High $131.83 | Professional | 54 · Surgery only | $89.13 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.91 Typical High $26.30 | Professional | 55 · Aftercare only | $17.78 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.14 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.75 | $15.14 | $17.38 |
Where Indiana sits
The same service costs 3.7 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· 42nd of 51
$178
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.