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 $87.10 Median $165.96 Typical High $5,011.87 | Facility | None | $87.10 | $165.96 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $128.82 Typical High $181.97 | Professional | None | $77.62 | $128.82 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $190.55 | Professional | None | $87.10 | $134.90 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $186.21 | Facility | None | $95.50 | $95.50 | $186.21 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $199.53 | Professional | None | $144.54 | $162.18 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $186.21 Typical High $933.25 | Facility | None | $114.82 | $186.21 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $208.93 | Professional | None | $97.72 | $138.04 | $208.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $169.82 Median $251.19 Typical High $3,090.30 | Facility | None | $169.82 | $251.19 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $218.78 | Professional | None | $102.33 | $162.18 | $218.78 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $234.42 | Professional | None | $87.10 | $141.25 | $234.42 |
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 $38.90 Median $63.10 Typical High $72.44 | Professional | 52 · Reduced service | $38.90 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $25.12 Typical High $28.84 | Professional | 53 · Discontinued | $15.49 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $95.50 Typical High $109.65 | Professional | 54 · Surgery only | $58.88 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $19.05 Typical High $21.88 | Professional | 55 · Aftercare only | $11.75 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.59 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.76 | $12.59 | $14.45 |
Where Indiana sits
The same service costs 3.2 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· 42nd of 51
$148
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.