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 $85.11 Median $1,380.38 Typical High $5,011.87 | Facility | None | $85.11 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $218.78 Typical High $707.95 | Professional | None | $85.11 | $218.78 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $177.83 | Facility | None | $93.33 | $93.33 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $147.91 Typical High $263.03 | Professional | None | $75.86 | $147.91 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $1,202.26 | Professional | None | $93.33 | $194.98 | $1,202.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $181.97 Median $954.99 Typical High $2,137.96 | Facility | None | $181.97 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $102.33 Median $204.17 Typical High $1,047.13 | Professional | None | $102.33 | $204.17 | $1,047.13 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $6,760.83 Typical High $12,589.25 | Facility | None | $2,137.96 | $6,760.83 | $12,589.25 |
United Setting Professional Modifier None Typical Low $87.10 Median $186.21 Typical High $707.95 | Professional | None | $87.10 | $186.21 | $707.95 |
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 $42.66 Median $109.65 Typical High $354.81 | Professional | 52 · Reduced service | $42.66 | $109.65 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $43.65 Typical High $141.25 | Professional | 53 · Discontinued | $16.98 | $43.65 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $162.18 Typical High $537.03 | Professional | 54 · Surgery only | $64.57 | $162.18 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $32.36 Typical High $107.15 | Professional | 55 · Aftercare only | $12.88 | $32.36 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $21.88 Typical High $70.79 | Professional | 56 · Pre-op care only | $8.51 | $21.88 | $70.79 |
Where Indiana sits
The same service costs 9.5 times more in Washington 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· 48th of 51
$158
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.