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 $22.91 Median $3,801.89 Typical High $5,623.41 | Facility | None | $22.91 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $45.71 Typical High $54.95 | Professional | None | $22.91 | $45.71 | $54.95 |
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 $23.99 Median $44.67 Typical High $67.61 | Professional | None | $23.99 | $44.67 | $67.61 |
CareSource Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $75.86 | Facility | None | $27.54 | $27.54 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $100.00 | Facility | None | $43.65 | $66.07 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $83.18 | Professional | None | $29.51 | $51.29 | $83.18 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $1,995.26 | Facility | None | $70.79 | $104.71 | $1,995.26 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $30.90 Median $52.48 Typical High $83.18 | Professional | None | $30.90 | $52.48 | $83.18 |
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 $25.70 Median $44.67 Typical High $83.18 | Professional | None | $25.70 | $44.67 | $83.18 |
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 $11.48 Median $20.89 Typical High $26.30 | Professional | 52 · Reduced service | $11.48 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $8.32 Typical High $10.47 | Professional | 53 · Discontinued | $4.57 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.38 Median $31.62 Typical High $38.90 | Professional | 54 · Surgery only | $17.38 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $6.31 Typical High $7.76 | Professional | 55 · Aftercare only | $3.47 | $6.31 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $4.17 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.29 | $4.17 | $5.25 |
Where Indiana sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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· 45th of 51
$48.98
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.