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 $83.18 Median $389.05 Typical High $5,495.41 | Facility | None | $83.18 | $389.05 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $213.80 Typical High $354.81 | Professional | None | $75.86 | $213.80 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $245.47 Typical High $40,738.03 | Facility | None | $128.82 | $245.47 | $40,738.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $128.82 Typical High $181.97 | Professional | None | $64.57 | $128.82 | $181.97 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $97.72 Median $190.55 Typical High $269.15 | Professional | 50 · Both sides | $97.72 | $190.55 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $181.97 Typical High $549.54 | Professional | None | $87.10 | $181.97 | $549.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $199.53 Median $912.01 Typical High $2,187.76 | Facility | None | $199.53 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $100.00 Median $323.59 Typical High $588.84 | Professional | None | $100.00 | $323.59 | $588.84 |
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 $81.28 Median $218.78 Typical High $478.63 | Professional | None | $81.28 | $218.78 | $478.63 |
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 $38.02 Median $117.49 Typical High $151.36 | Professional | 52 · Reduced service | $38.02 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $46.77 Typical High $61.66 | Professional | 53 · Discontinued | $15.14 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $177.83 Typical High $229.09 | Professional | 54 · Surgery only | $57.54 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $35.48 Typical High $45.71 | Professional | 55 · Aftercare only | $11.48 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $23.44 Typical High $30.90 | Professional | 56 · Pre-op care only | $7.59 | $23.44 | $30.90 |
Where Indiana sits
The same service costs 4.2 times more in Washington 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· 49th of 51
$129
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.