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 $56.23 Median $1,380.38 Typical High $5,011.87 | Facility | None | $56.23 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $104.71 | Professional | None | $56.23 | $77.62 | $104.71 |
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 $46.77 Median $85.11 Typical High $131.83 | Professional | None | $46.77 | $85.11 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $102.33 Typical High $794.33 | Facility | None | $61.66 | $102.33 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $162.18 | Professional | None | $61.66 | $91.20 | $162.18 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $954.99 | Facility | None | $91.20 | $151.36 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $151.36 | Professional | None | $58.88 | $97.72 | $151.36 |
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 $56.23 Median $91.20 Typical High $144.54 | Professional | None | $56.23 | $91.20 | $144.54 |
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 $28.18 Median $38.90 Typical High $44.67 | Professional | 52 · Reduced service | $28.18 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $15.49 Typical High $18.20 | Professional | 53 · Discontinued | $11.22 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $58.88 Typical High $67.61 | Professional | 54 · Surgery only | $42.66 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $11.75 Typical High $13.49 | Professional | 55 · Aftercare only | $8.51 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.76 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.62 | $7.76 | $8.91 |
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· 40th of 51
$91.20
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.