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 $186.21 Typical High $5,011.87 | Facility | None | $83.18 | $186.21 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $186.21 | Professional | None | $72.44 | $123.03 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $208.93 | Professional | None | $107.15 | $128.82 | $208.93 |
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 $60.26 Median $114.82 Typical High $194.98 | Professional | None | $60.26 | $114.82 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $208.93 | Facility | None | $75.86 | $75.86 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $186.21 | Professional | None | $131.83 | $154.88 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $208.93 Typical High $794.33 | Facility | None | $128.82 | $208.93 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $138.04 Typical High $239.88 | Professional | None | $72.44 | $138.04 | $239.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $190.55 Median $269.15 Typical High $2,089.30 | Facility | None | $190.55 | $269.15 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $251.19 | Professional | None | $77.62 | $147.91 | $251.19 |
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 $72.44 Median $128.82 Typical High $229.09 | Professional | None | $72.44 | $128.82 | $229.09 |
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 $36.31 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $36.31 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $25.12 Typical High $30.20 | Professional | 53 · Discontinued | $14.79 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $95.50 Typical High $114.82 | Professional | 54 · Surgery only | $54.95 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $10.96 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $12.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.24 | $12.59 | $15.14 |
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
$145
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.