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 $45.71 Median $3,801.89 Typical High $5,623.41 | Facility | None | $45.71 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $93.33 | Professional | None | $45.71 | $63.10 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $1,621.81 Typical High $5,248.07 | Facility | None | $60.26 | $1,621.81 | $5,248.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $154.88 | Professional | None | $77.62 | $109.65 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $1,000.00 Typical High $1,513.56 | Facility | None | $67.61 | $1,000.00 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $95.50 Typical High $630.96 | Facility | None | $63.10 | $95.50 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $199.53 | Professional | None | $112.20 | $199.53 | $199.53 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $117.49 Median $302.00 Typical High $2,137.96 | Facility | None | $117.49 | $302.00 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $13.49 Median $60.26 Typical High $93.33 | Professional | None | $13.49 | $60.26 | $93.33 |
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 $60.26 Median $97.72 Typical High $154.88 | Professional | None | $60.26 | $97.72 | $154.88 |
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 $22.91 Median $30.20 Typical High $44.67 | Professional | 52 · Reduced service | $22.91 | $30.20 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $12.30 Typical High $17.78 | Professional | 53 · Discontinued | $9.12 | $12.30 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $45.71 Typical High $66.07 | Professional | 54 · Surgery only | $33.88 | $45.71 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $9.12 Typical High $13.49 | Professional | 55 · Aftercare only | $6.76 | $9.12 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.17 Typical High $8.91 | Professional | 56 · Pre-op care only | $4.57 | $6.17 | $8.91 |
Where Indiana sits
The same service costs 3.4 times more in Alaska than in 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· 32nd of 51
$110
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.