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 $25.12 Median $58.88 Typical High $5,011.87 | Facility | None | $25.12 | $58.88 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $43.65 Typical High $74.13 | Professional | None | $25.12 | $43.65 | $74.13 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $74.13 | Professional | None | $40.74 | $53.70 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $3,162.28 Typical High $6,309.57 | Facility | None | $549.54 | $3,162.28 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $52.48 Typical High $66.07 | Professional | None | $25.70 | $52.48 | $66.07 |
CareSource Setting Facility Modifier None Typical Low $30.20 Median $616.60 Typical High $912.01 | Facility | None | $30.20 | $616.60 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $70.79 | Professional | None | $52.48 | $57.54 | $70.79 |
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 $30.90 Median $45.71 Typical High $81.28 | Professional | None | $30.90 | $45.71 | $81.28 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $69.18 Median $288.40 Typical High $2,089.30 | Facility | None | $69.18 | $288.40 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $29.51 Median $56.23 Typical High $79.43 | Professional | None | $29.51 | $56.23 | $79.43 |
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 $27.54 Median $45.71 Typical High $81.28 | Professional | None | $27.54 | $45.71 | $81.28 |
6 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 $12.59 Median $21.88 Typical High $26.30 | Professional | 52 · Reduced service | $12.59 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $8.71 Typical High $10.47 | Professional | 53 · Discontinued | $5.01 | $8.71 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $33.11 Typical High $38.90 | Professional | 54 · Surgery only | $18.62 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $6.61 Typical High $7.76 | Professional | 55 · Aftercare only | $3.80 | $6.61 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $4.37 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.51 | $4.37 | $5.25 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $47.86 Median $47.86 Typical High $53.70 | Professional | 59 · Distinct service | $47.86 | $47.86 | $53.70 |
Where Indiana sits
The same service costs 3.5 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· 30th of 51
$53.70
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.