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 $38.02 Median $67.61 Typical High $5,495.41 | Facility | None | $38.02 | $67.61 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $63.10 | Professional | None | $32.36 | $43.65 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $31.62 Median $45.71 Typical High $61.66 | Professional | None | $31.62 | $45.71 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,162.28 Typical High $6,165.95 | Facility | None | $616.60 | $3,162.28 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $67.61 Typical High $83.18 | Professional | None | $30.90 | $67.61 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $56.23 | Facility | None | $37.15 | $37.15 | $56.23 |
CareSource Setting Professional Modifier None Typical Low $46.77 Median $52.48 Typical High $66.07 | Professional | None | $46.77 | $52.48 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $56.23 Typical High $794.33 | Facility | None | $33.88 | $56.23 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $112.20 | Professional | None | $39.81 | $56.23 | $112.20 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $52.48 Median $138.04 Typical High $954.99 | Facility | None | $52.48 | $138.04 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $91.20 | Professional | None | $40.74 | $66.07 | $91.20 |
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 $33.88 Median $48.98 Typical High $85.11 | Professional | None | $33.88 | $48.98 | $85.11 |
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 $17.38 Median $21.38 Typical High $26.30 | Professional | 52 · Reduced service | $17.38 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $8.51 Typical High $10.47 | Professional | 53 · Discontinued | $6.92 | $8.51 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $31.62 Typical High $38.90 | Professional | 54 · Surgery only | $26.30 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.31 Typical High $7.76 | Professional | 55 · Aftercare only | $5.25 | $6.31 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.27 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.47 | $4.27 | $5.25 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 59 · Distinct service | $45.71 | $45.71 | $45.71 |
Where Indiana sits
The same service costs 4.2 times more in Alaska than in New York. 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· 40th of 51
$52.48
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.