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 $46.77 Median $158.49 Typical High $3,801.89 | Facility | None | $46.77 | $158.49 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $123.03 Typical High $186.21 | Professional | None | $46.77 | $123.03 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $47.86 Typical High $151.36 | Professional | None | $32.36 | $47.86 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $223.87 | Facility | None | $117.49 | $117.49 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $117.49 Typical High $158.49 | Professional | None | $39.81 | $117.49 | $158.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $60.26 Median $173.78 Typical High $234.42 | Professional | 50 · Both sides | $60.26 | $173.78 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $218.78 | Professional | None | $138.04 | $144.54 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $147.91 Typical High $354.81 | Professional | None | $54.95 | $147.91 | $354.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $123.03 Median $446.68 Typical High $2,187.76 | Facility | None | $123.03 | $446.68 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $60.26 Median $169.82 Typical High $302.00 | Professional | None | $60.26 | $169.82 | $302.00 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $4,570.88 | Facility | None | $933.25 | $2,290.87 | $4,570.88 |
United Setting Professional Modifier None Typical Low $50.12 Median $125.89 Typical High $263.03 | Professional | None | $50.12 | $125.89 | $263.03 |
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 $23.44 Median $61.66 Typical High $79.43 | Professional | 52 · Reduced service | $23.44 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $25.12 Typical High $32.36 | Professional | 53 · Discontinued | $9.33 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $93.33 Typical High $120.23 | Professional | 54 · Surgery only | $35.48 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $18.62 Typical High $23.99 | Professional | 55 · Aftercare only | $7.08 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $12.30 Typical High $15.85 | Professional | 56 · Pre-op care only | $4.68 | $12.30 | $15.85 |
Where Indiana sits
The same service costs 3.9 times more in Alaska than in Virginia. 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
$117
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.