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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $257.04 | Professional | None | $199.53 | $213.80 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | None | $158.49 | $186.21 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $616.60 Typical High $812.83 | Facility | None | $177.83 | $616.60 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $269.15 | Professional | None | $151.36 | $177.83 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $309.03 | Professional | None | $199.53 | $234.42 | $309.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $288.40 Median $645.65 Typical High $2,187.76 | Facility | None | $288.40 | $645.65 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $398.11 | Professional | None | $223.87 | $302.00 | $398.11 |
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 $162.18 Median $204.17 Typical High $371.54 | Professional | None | $162.18 | $204.17 | $371.54 |
4 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 $100.00 Median $107.15 Typical High $117.49 | Professional | 52 · Reduced service | $100.00 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $42.66 Typical High $47.86 | Professional | 53 · Discontinued | $40.74 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $31.62 Typical High $35.48 | Professional | 55 · Aftercare only | $30.20 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.95 | $21.38 | $23.44 |
Where Indiana sits
The same service costs 3.0 times more in Wisconsin than in Florida. 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
$204
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.