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 $43.65 Median $81.28 Typical High $5,495.41 | Facility | None | $43.65 | $81.28 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $47.86 Typical High $69.18 | Professional | None | $37.15 | $47.86 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $95.50 | Professional | None | $60.26 | $63.10 | $95.50 |
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 $33.88 Median $54.95 Typical High $69.18 | Professional | None | $33.88 | $54.95 | $69.18 |
CareSource Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $77.62 | Facility | None | $41.69 | $41.69 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $83.18 | Professional | None | $58.88 | $64.57 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $83.18 Typical High $794.33 | Facility | None | $51.29 | $83.18 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $123.03 | Professional | None | $42.66 | $64.57 | $123.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $72.44 Median $138.04 Typical High $954.99 | Facility | None | $72.44 | $138.04 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $123.03 | Professional | None | $48.98 | $79.43 | $123.03 |
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 $36.31 Median $54.95 Typical High $95.50 | Professional | None | $36.31 | $54.95 | $95.50 |
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 $19.05 Median $26.30 Typical High $31.62 | Professional | 52 · Reduced service | $19.05 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $10.47 Typical High $12.59 | Professional | 53 · Discontinued | $7.59 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $39.81 Typical High $47.86 | Professional | 54 · Surgery only | $28.84 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.94 Typical High $9.55 | Professional | 55 · Aftercare only | $5.75 | $7.94 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.25 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.80 | $5.25 | $6.31 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 41st of 51
$58.88
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.