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 $15.49 Median $38.90 Typical High $5,495.41 | Facility | None | $15.49 | $38.90 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $25.12 Typical High $33.88 | Professional | None | $14.13 | $25.12 | $33.88 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | None | $38.90 | $40.74 | $42.66 |
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 $12.30 Median $26.30 Typical High $38.02 | Professional | None | $12.30 | $26.30 | $38.02 |
CareSource Setting Facility Modifier None Typical Low $14.79 Median $616.60 Typical High $912.01 | Facility | None | $14.79 | $616.60 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $40.74 | Professional | None | $30.20 | $33.11 | $40.74 |
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 $15.49 Median $24.55 Typical High $46.77 | Professional | None | $15.49 | $24.55 | $46.77 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $38.90 Median $93.33 Typical High $2,089.30 | Facility | None | $38.90 | $93.33 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $15.85 Median $25.12 Typical High $43.65 | Professional | None | $15.85 | $25.12 | $43.65 |
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 $13.18 Median $25.12 Typical High $47.86 | Professional | None | $13.18 | $25.12 | $47.86 |
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 $7.08 Median $12.02 Typical High $16.22 | Professional | 52 · Reduced service | $7.08 | $12.02 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $4.90 Typical High $6.46 | Professional | 53 · Discontinued | $2.82 | $4.90 | $6.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $18.20 Typical High $23.99 | Professional | 54 · Surgery only | $10.72 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.34 Typical High $4.79 | Professional | 55 · Aftercare only | $2.14 | $2.34 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $2.45 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.41 | $2.45 | $3.24 |
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· 31st of 51
$30.90
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.