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 $26.30 Median $54.95 Typical High $5,495.41 | Facility | None | $26.30 | $54.95 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $38.02 Typical High $58.88 | Professional | None | $22.91 | $38.02 | $58.88 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $58.88 | Professional | None | $43.65 | $58.88 | $58.88 |
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 $20.89 Median $37.15 Typical High $56.23 | Professional | None | $20.89 | $37.15 | $56.23 |
CareSource Setting Facility Modifier None Typical Low $24.55 Median $616.60 Typical High $912.01 | Facility | None | $24.55 | $616.60 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $40.74 Median $45.71 Typical High $56.23 | Professional | None | $40.74 | $45.71 | $56.23 |
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 $25.70 Median $41.69 Typical High $70.79 | Professional | None | $25.70 | $41.69 | $70.79 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $61.66 Median $123.03 Typical High $2,089.30 | Facility | None | $61.66 | $123.03 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $26.30 Median $44.67 Typical High $63.10 | Professional | None | $26.30 | $44.67 | $63.10 |
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 $22.39 Median $38.02 Typical High $66.07 | Professional | None | $22.39 | $38.02 | $66.07 |
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 $11.48 Median $17.38 Typical High $21.88 | Professional | 52 · Reduced service | $11.48 | $17.38 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $6.92 Typical High $8.71 | Professional | 53 · Discontinued | $4.57 | $6.92 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.38 Median $25.70 Typical High $33.11 | Professional | 54 · Surgery only | $17.38 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $5.13 Typical High $6.61 | Professional | 55 · Aftercare only | $3.47 | $5.13 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $3.47 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.29 | $3.47 | $4.37 |
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· 36th of 51
$42.66
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.