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 $1.78 Median $11.48 Typical High $5,623.41 | Facility | None | $1.78 | $11.48 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $4.90 Typical High $8.32 | Professional | None | $1.78 | $4.90 | $8.32 |
Ambetter Setting Professional Modifier None Typical Low $4.68 Median $6.03 Typical High $8.91 | Professional | None | $4.68 | $6.03 | $8.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,621.81 | Facility | None | $602.56 | $1,071.52 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.91 Median $6.03 Typical High $12.88 | Professional | None | $1.91 | $6.03 | $12.88 |
CareSource Setting Facility Modifier None Typical Low $2.04 Median $616.60 Typical High $912.01 | Facility | None | $2.04 | $616.60 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $6.03 Median $6.61 Typical High $8.13 | Professional | None | $6.03 | $6.61 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $724.44 Typical High $2,691.53 | Facility | None | $50.12 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $7.59 Typical High $14.45 | Professional | None | $2.24 | $7.59 | $14.45 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $5.25 Median $22.39 Typical High $2,187.76 | Facility | None | $5.25 | $22.39 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2.29 Median $3.98 Typical High $11.48 | Professional | None | $2.29 | $3.98 | $11.48 |
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 $1.95 Median $5.25 Typical High $9.77 | Professional | None | $1.95 | $5.25 | $9.77 |
7 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 $0.87 Median $2.63 Typical High $2.95 | Professional | 52 · Reduced service | $0.87 | $2.63 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $1.07 Typical High $1.17 | Professional | 53 · Discontinued | $0.35 | $1.07 | $1.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.32 Median $3.89 Typical High $4.47 | Professional | 54 · Surgery only | $1.32 | $3.89 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.78 Typical High $0.89 | Professional | 55 · Aftercare only | $0.26 | $0.78 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.52 Typical High $0.59 | Professional | 56 · Pre-op care only | $0.18 | $0.52 | $0.59 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $4.68 Median $5.50 Typical High $7.24 | Professional | 59 · Distinct service | $4.68 | $5.50 | $7.24 |
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | XS · Separate structure | $6.03 | $6.03 | $7.08 |
Where Indiana sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 37th of 51
$6.03
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.