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 $60.26 Median $3,801.89 Typical High $5,623.41 | Facility | None | $60.26 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $102.33 | Professional | None | $60.26 | $75.86 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $97.72 | Professional | None | $52.48 | $77.62 | $97.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $114.82 Typical High $144.54 | Professional | 50 · Both sides | $79.43 | $114.82 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $100.00 | Facility | None | $67.61 | $67.61 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $524.81 | Facility | None | $63.10 | $93.33 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $141.25 | Professional | None | $67.61 | $89.13 | $141.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $102.33 Median $245.47 Typical High $954.99 | Facility | None | $102.33 | $245.47 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $165.96 | Professional | None | $75.86 | $117.49 | $165.96 |
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 $58.88 Median $79.43 Typical High $134.90 | Professional | None | $58.88 | $79.43 | $134.90 |
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 $30.20 Median $35.48 Typical High $44.67 | Professional | 52 · Reduced service | $30.20 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $14.45 Typical High $17.78 | Professional | 53 · Discontinued | $12.02 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $53.70 Typical High $66.07 | Professional | 54 · Surgery only | $45.71 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.72 Typical High $13.18 | Professional | 55 · Aftercare only | $9.12 | $10.72 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.24 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.03 | $7.24 | $8.91 |
Where Indiana sits
The same service costs 3.8 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· 44th of 51
$81.28
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.