How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $128.82 Median $3,467.37 Typical High $5,011.87 | Facility | None | $128.82 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $245.47 | Professional | None | $128.82 | $128.82 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $1,995.26 Typical High $2,630.27 | Facility | None | $218.78 | $1,995.26 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $338.84 | Professional | None | $218.78 | $218.78 | $338.84 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $234.42 | Professional | None | $162.18 | $186.21 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $154.88 | Professional | None | $117.49 | $144.54 | $154.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $457.09 Median $1,202.26 Typical High $2,398.83 | Facility | None | $457.09 | $1,202.26 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $346.74 | Professional | None | $147.91 | $245.47 | $346.74 |
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 $64.57 Median $64.57 Typical High $123.03 | Professional | 52 · Reduced service | $64.57 | $64.57 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $48.98 | Professional | 53 · Discontinued | $25.70 | $25.70 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $181.97 | Professional | 54 · Surgery only | $95.50 | $95.50 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $37.15 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $24.55 |
Where Indiana sits
The same service costs 7.6 times more in Nebraska than in West Virginia. 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· 31st of 51
$219
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.