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 $20.89 Median $3,801.89 Typical High $5,623.41 | Facility | None | $20.89 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $26.92 Typical High $36.31 | Professional | None | $20.89 | $26.92 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $602.56 Typical High $2,818.38 | Facility | None | $25.70 | $602.56 | $2,818.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $29.51 Typical High $42.66 | Professional | None | $21.38 | $29.51 | $42.66 |
CareSource Setting Facility Modifier None Typical Low $25.70 Median $831.76 Typical High $1,230.27 | Facility | None | $25.70 | $831.76 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $724.44 Typical High $2,691.53 | Facility | None | $346.74 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $33.88 Typical High $48.98 | Professional | None | $26.30 | $33.88 | $48.98 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $63.10 Median $66.07 Typical High $100.00 | Facility | None | $63.10 | $66.07 | $100.00 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $31.62 Median $33.11 Typical High $43.65 | Professional | None | $31.62 | $33.11 | $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 $22.39 Median $33.11 Typical High $51.29 | Professional | None | $22.39 | $33.11 | $51.29 |
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 $10.47 Median $13.49 Typical High $15.14 | Professional | 52 · Reduced service | $10.47 | $13.49 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $5.37 Typical High $6.03 | Professional | 53 · Discontinued | $4.17 | $5.37 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $20.42 Typical High $22.91 | Professional | 54 · Surgery only | $15.49 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $4.07 Typical High $4.57 | Professional | 55 · Aftercare only | $3.09 | $4.07 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.69 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.09 | $2.69 | $3.02 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 58 · Staged procedure | $25.70 | $25.70 | $25.70 |
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· 43rd of 51
$31.62
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.