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 $50.12 Median $1,380.38 Typical High $5,011.87 | Facility | None | $50.12 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $97.72 Typical High $169.82 | Professional | None | $50.12 | $97.72 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $158.49 | Professional | None | $112.20 | $112.20 | $158.49 |
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 $50.12 Median $93.33 Typical High $134.90 | Professional | None | $50.12 | $93.33 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $616.60 Typical High $912.01 | Facility | None | $60.26 | $616.60 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $165.96 | Professional | None | $123.03 | $134.90 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $93.33 Typical High $165.96 | Professional | None | $61.66 | $93.33 | $165.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $138.04 Median $371.54 Typical High $2,089.30 | Facility | None | $138.04 | $371.54 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $190.55 | Professional | None | $66.07 | $104.71 | $190.55 |
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 $54.95 Median $97.72 Typical High $190.55 | Professional | None | $54.95 | $97.72 | $190.55 |
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 $25.12 Median $42.66 Typical High $63.10 | Professional | 52 · Reduced service | $25.12 | $42.66 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $17.38 Typical High $25.12 | Professional | 53 · Discontinued | $10.00 | $17.38 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $64.57 Typical High $93.33 | Professional | 54 · Surgery only | $37.15 | $64.57 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.88 Typical High $18.62 | Professional | 55 · Aftercare only | $7.59 | $12.88 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $8.51 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.01 | $8.51 | $12.59 |
Where Indiana sits
The same service costs 3.5 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· 40th of 51
$107
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.