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 $173.78 Median $3,801.89 Typical High $5,623.41 | Facility | None | $173.78 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $380.19 | Professional | None | $173.78 | $275.42 | $380.19 |
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 $151.36 Median $416.87 Typical High $549.54 | Professional | None | $151.36 | $416.87 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $1,659.59 | Facility | None | $524.81 | $724.44 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $549.54 | Professional | None | $288.40 | $288.40 | $549.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $2,137.96 | Facility | None | $457.09 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $426.58 | Professional | None | $199.53 | $263.03 | $426.58 |
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 $199.53 Median $380.19 Typical High $776.25 | Professional | None | $199.53 | $380.19 | $776.25 |
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 $87.10 Median $131.83 Typical High $190.55 | Professional | 52 · Reduced service | $87.10 | $131.83 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $52.48 Typical High $75.86 | Professional | 53 · Discontinued | $34.67 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $194.98 Typical High $288.40 | Professional | 54 · Surgery only | $128.82 | $194.98 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $38.90 Typical High $57.54 | Professional | 55 · Aftercare only | $25.70 | $38.90 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.30 Typical High $38.02 | Professional | 56 · Pre-op care only | $17.38 | $26.30 | $38.02 |
Where Indiana sits
The same service costs 2.8 times more in Wisconsin 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· 15th of 51
$417
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.