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 $52.48 Median $245.47 Typical High $5,495.41 | Facility | None | $52.48 | $245.47 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $147.91 Typical High $208.93 | Professional | None | $47.86 | $147.91 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $134.90 Typical High $1,071.52 | Facility | None | $75.86 | $134.90 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $75.86 Typical High $93.33 | Professional | None | $40.74 | $75.86 | $93.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $61.66 Median $114.82 Typical High $141.25 | Professional | 50 · Both sides | $61.66 | $114.82 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $616.60 Typical High $912.01 | Facility | None | $52.48 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,290.87 Typical High $2,691.53 | Facility | None | $524.81 | $2,290.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $173.78 Typical High $467.74 | Professional | None | $53.70 | $173.78 | $467.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $123.03 Median $588.84 Typical High $2,187.76 | Facility | None | $123.03 | $588.84 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $58.88 Median $147.91 Typical High $407.38 | Professional | None | $58.88 | $147.91 | $407.38 |
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 $46.77 Median $128.82 Typical High $288.40 | Professional | None | $46.77 | $128.82 | $288.40 |
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 $23.99 Median $79.43 Typical High $104.71 | Professional | 52 · Reduced service | $23.99 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $31.62 Typical High $41.69 | Professional | 53 · Discontinued | $9.55 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $120.23 Typical High $154.88 | Professional | 54 · Surgery only | $35.48 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $23.99 Typical High $31.62 | Professional | 55 · Aftercare only | $7.08 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $15.85 Typical High $20.89 | Professional | 56 · Pre-op care only | $4.79 | $15.85 | $20.89 |
Where Indiana sits
The same service costs 4.6 times more in Iowa than in Kentucky. 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· 48th of 51
$75.86
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.