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 $46.77 Median $1,380.38 Typical High $5,011.87 | Facility | None | $46.77 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $114.82 | Professional | None | $45.71 | $67.61 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $109.65 | Professional | None | $57.54 | $91.20 | $109.65 |
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 $41.69 Median $72.44 Typical High $144.54 | Professional | None | $41.69 | $72.44 | $144.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $61.66 Median $109.65 Typical High $218.78 | Professional | 50 · Both sides | $61.66 | $109.65 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $194.98 | Professional | None | $57.54 | $89.13 | $194.98 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $125.89 Median $288.40 Typical High $2,089.30 | Facility | None | $125.89 | $288.40 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $51.29 Median $87.10 Typical High $134.90 | Professional | None | $51.29 | $87.10 | $134.90 |
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 $52.48 Median $87.10 Typical High $151.36 | Professional | None | $52.48 | $87.10 | $151.36 |
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 $22.91 Median $33.11 Typical High $35.48 | Professional | 52 · Reduced service | $22.91 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $13.18 Typical High $14.13 | Professional | 53 · Discontinued | $9.12 | $13.18 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $48.98 Typical High $53.70 | Professional | 54 · Surgery only | $34.67 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $10.00 Typical High $10.72 | Professional | 55 · Aftercare only | $6.92 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.61 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.57 | $6.61 | $7.08 |
Where Indiana sits
The same service costs 3.2 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· 37th of 51
$85.11
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.