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 $77.62 Median $3,801.89 Typical High $5,623.41 | Facility | None | $77.62 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $162.18 | Professional | None | $77.62 | $120.23 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $177.83 | Professional | None | $104.71 | $104.71 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $1,621.81 Typical High $5,370.32 | Facility | None | $83.18 | $1,621.81 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $190.55 | Professional | None | $75.86 | $134.90 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $151.36 | Facility | None | $95.50 | $95.50 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $158.49 Typical High $794.33 | Facility | None | $95.50 | $158.49 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $229.09 | Professional | None | $95.50 | $134.90 | $229.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $141.25 Median $257.04 Typical High $2,089.30 | Facility | None | $141.25 | $257.04 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $204.17 | Professional | None | $100.00 | $158.49 | $204.17 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $213.80 | Professional | None | $85.11 | $134.90 | $213.80 |
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 $38.02 Median $58.88 Typical High $67.61 | Professional | 52 · Reduced service | $38.02 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $23.44 Typical High $26.92 | Professional | 53 · Discontinued | $15.49 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $87.10 Typical High $102.33 | Professional | 54 · Surgery only | $57.54 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $11.48 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $11.75 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.76 | $11.75 | $13.49 |
Where Indiana sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$138
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.