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 $25.70 Median $3,801.89 Typical High $5,623.41 | Facility | None | $25.70 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $56.23 Typical High $66.07 | Professional | None | $25.70 | $56.23 | $66.07 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $53.70 Typical High $1,071.52 | Facility | None | $30.90 | $53.70 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $48.98 Typical High $72.44 | Professional | None | $25.12 | $48.98 | $72.44 |
CareSource Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $2,691.53 | Facility | None | $524.81 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $50.12 Typical High $89.13 | Professional | None | $32.36 | $50.12 | $89.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $72.44 Median $199.53 Typical High $2,187.76 | Facility | None | $72.44 | $199.53 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $30.20 Median $66.07 Typical High $100.00 | Professional | None | $30.20 | $66.07 | $100.00 |
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 $28.18 Median $54.95 Typical High $104.71 | Professional | None | $28.18 | $54.95 | $104.71 |
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 $12.88 Median $28.18 Typical High $32.36 | Professional | 52 · Reduced service | $12.88 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $11.22 Typical High $13.18 | Professional | 53 · Discontinued | $5.13 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $42.66 Typical High $48.98 | Professional | 54 · Surgery only | $19.05 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $8.51 Typical High $9.77 | Professional | 55 · Aftercare only | $3.80 | $8.51 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $5.62 Typical High $6.61 | Professional | 56 · Pre-op care only | $2.51 | $5.62 | $6.61 |
Where Indiana sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 47th of 51
$57.54
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.