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 $588.84 Median $5,011.87 Typical High $19,498.45 | Facility | None | $588.84 | $5,011.87 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $676.08 | Professional | None | $562.34 | $588.84 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,412.54 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $524.81 | Professional | None | $218.78 | $257.04 | $524.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $389.05 Typical High $794.33 | Professional | 50 · Both sides | $331.13 | $389.05 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $21,877.62 | Facility | None | $645.65 | $645.65 | $21,877.62 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $12,589.25 Typical High $22,387.21 | Facility | None | $645.65 | $12,589.25 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $977.24 | Professional | None | $630.96 | $776.25 | $977.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $18,620.87 Typical High $26,302.68 | Facility | None | $954.99 | $18,620.87 | $26,302.68 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,148.15 | Professional | None | $630.96 | $776.25 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,230.27 | Professional | None | $588.84 | $758.58 | $1,230.27 |
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 $281.84 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $281.84 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $112.20 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $436.52 Typical High $457.09 | Professional | 54 · Surgery only | $416.87 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $56.23 | $58.88 | $63.10 |
Where Indiana sits
The same service costs 11.7 times more in Oklahoma than in Utah. 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· 46th of 51
$646
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.