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 $114.82 Median $204.17 Typical High $5,623.41 | Facility | None | $114.82 | $204.17 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $134.90 | Professional | None | $100.00 | $107.15 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $812.83 Typical High $1,621.81 | Facility | None | $141.25 | $812.83 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $181.97 | Professional | None | $123.03 | $162.18 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $1,548.82 Typical High $2,344.23 | Facility | None | $117.49 | $1,548.82 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $151.36 | Professional | None | $104.71 | $114.82 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $7,079.46 | Facility | None | $524.81 | $724.44 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $831.76 | Professional | None | $104.71 | $134.90 | $831.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,290.87 | Facility | None | $912.01 | $954.99 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $371.54 | Professional | None | $186.21 | $309.03 | $371.54 |
United Setting Facility Modifier None Typical Low $109.65 Median $870.96 Typical High $4,265.80 | Facility | None | $109.65 | $870.96 | $4,265.80 |
United Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $208.93 | Professional | None | $95.50 | $125.89 | $208.93 |
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 $48.98 Median $53.70 Typical High $60.26 | Professional | 52 · Reduced service | $48.98 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.38 Typical High $23.99 | Professional | 53 · Discontinued | $19.95 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $81.28 Typical High $89.13 | Professional | 54 · Surgery only | $74.13 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.22 Typical High $18.20 | Professional | 55 · Aftercare only | $14.79 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.72 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.77 | $10.72 | $12.02 |
Where Indiana sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 33rd of 51
$148
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.