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 $69.18 Median $269.15 Typical High $5,623.41 | Facility | None | $69.18 | $269.15 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $147.91 Typical High $194.98 | Professional | None | $69.18 | $147.91 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $269.15 | Facility | None | $138.04 | $138.04 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $138.04 Typical High $186.21 | Professional | None | $58.88 | $138.04 | $186.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $208.93 Typical High $281.84 | Professional | 50 · Both sides | $87.10 | $208.93 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $120.23 Typical High $331.13 | Facility | None | $75.86 | $120.23 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $177.83 Typical High $478.63 | Professional | None | $77.62 | $177.83 | $478.63 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $177.83 Median $537.03 Typical High $2,187.76 | Facility | None | $177.83 | $537.03 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $85.11 Median $204.17 Typical High $363.08 | Professional | None | $85.11 | $204.17 | $363.08 |
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 $74.13 Median $158.49 Typical High $323.59 | Professional | None | $74.13 | $158.49 | $323.59 |
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 $34.67 Median $75.86 Typical High $95.50 | Professional | 52 · Reduced service | $34.67 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $30.20 Typical High $38.02 | Professional | 53 · Discontinued | $13.80 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $112.20 Typical High $144.54 | Professional | 54 · Surgery only | $51.29 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $22.39 Typical High $28.84 | Professional | 55 · Aftercare only | $10.23 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $15.14 Typical High $19.05 | Professional | 56 · Pre-op care only | $6.92 | $15.14 | $19.05 |
Where Indiana sits
The same service costs 3.8 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· 43rd of 51
$138
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.