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 $46.77 Median $2,344.23 Typical High $5,623.41 | Facility | None | $46.77 | $2,344.23 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $123.03 Typical High $173.78 | Professional | None | $46.77 | $123.03 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $181.97 | Professional | None | $141.25 | $141.25 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $6,165.95 | Facility | None | $616.60 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $120.23 Typical High $177.83 | Professional | None | $48.98 | $120.23 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $229.09 | Facility | None | $57.54 | $57.54 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $229.09 Typical High $1,412.54 | Facility | None | $138.04 | $229.09 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $199.53 | Professional | None | $60.26 | $117.49 | $199.53 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $173.78 Median $426.58 Typical High $1,995.26 | Facility | None | $173.78 | $426.58 | $1,995.26 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $213.80 | Professional | None | $61.66 | $120.23 | $213.80 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $52.48 Median $109.65 Typical High $223.87 | Professional | None | $52.48 | $109.65 | $223.87 |
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 $23.44 Median $61.66 Typical High $70.79 | Professional | 52 · Reduced service | $23.44 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $24.55 Typical High $28.18 | Professional | 53 · Discontinued | $9.33 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $91.20 Typical High $107.15 | Professional | 54 · Surgery only | $35.48 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $7.08 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $12.30 Typical High $14.13 | Professional | 56 · Pre-op care only | $4.68 | $12.30 | $14.13 |
Where Indiana sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 35th of 51
$141
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.