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 $13.80 Median $1,380.38 Typical High $5,011.87 | Facility | None | $13.80 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $15.49 Typical High $23.99 | Professional | None | $13.80 | $15.49 | $23.99 |
Ambetter Setting Professional Modifier None Typical Low $13.49 Median $15.85 Typical High $23.99 | Professional | None | $13.49 | $15.85 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.85 Median $812.83 Typical High $1,621.81 | Facility | None | $15.85 | $812.83 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $18.20 Typical High $28.84 | Professional | None | $13.18 | $18.20 | $28.84 |
CareSource Setting Facility Modifier None Typical Low $16.22 Median $616.60 Typical High $912.01 | Facility | None | $16.22 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $2,089.30 Typical High $2,691.53 | Facility | None | $50.12 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $19.95 Typical High $32.36 | Professional | None | $16.60 | $19.95 | $32.36 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $37.15 Median $52.48 Typical High $2,187.76 | Facility | None | $37.15 | $52.48 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $16.22 Median $20.89 Typical High $31.62 | Professional | None | $16.22 | $20.89 | $31.62 |
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 $13.49 Median $18.20 Typical High $28.18 | Professional | None | $13.49 | $18.20 | $28.18 |
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 $6.92 Median $7.76 Typical High $8.91 | Professional | 52 · Reduced service | $6.92 | $7.76 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $3.09 Typical High $3.63 | Professional | 53 · Discontinued | $2.75 | $3.09 | $3.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.23 Median $11.48 Typical High $13.49 | Professional | 54 · Surgery only | $10.23 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.29 Typical High $2.69 | Professional | 55 · Aftercare only | $2.04 | $2.29 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.55 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.38 | $1.55 | $1.82 |
Where Indiana sits
The same service costs 3.9 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· 36th of 51
$18.62
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.