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 $52.48 Median $1,380.38 Typical High $5,011.87 | Facility | None | $52.48 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $154.88 | Professional | None | $52.48 | $93.33 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | None | $95.50 | $95.50 | $112.20 |
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 $53.70 Median $97.72 Typical High $154.88 | Professional | None | $53.70 | $97.72 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $190.55 | Facility | None | $64.57 | $64.57 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $169.82 | Professional | None | $123.03 | $134.90 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $144.54 Typical High $245.47 | Facility | None | $66.07 | $144.54 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $165.96 | Professional | None | $64.57 | $91.20 | $165.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $954.99 | Facility | None | $144.54 | $234.42 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $190.55 | Professional | None | $67.61 | $109.65 | $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 $56.23 Median $97.72 Typical High $186.21 | Professional | None | $56.23 | $97.72 | $186.21 |
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 $26.30 Median $41.69 Typical High $63.10 | Professional | 52 · Reduced service | $26.30 | $41.69 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $16.60 Typical High $25.12 | Professional | 53 · Discontinued | $10.47 | $16.60 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $61.66 Typical High $93.33 | Professional | 54 · Surgery only | $39.81 | $61.66 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.30 Typical High $18.62 | Professional | 55 · Aftercare only | $7.94 | $12.30 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.32 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.25 | $8.32 | $12.59 |
Where Indiana sits
The same service costs 3.2 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· 39th 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.