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 $63.10 Median $63.10 Typical High $89.13 | Facility | None | $63.10 | $63.10 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $109.65 | Professional | None | $57.54 | $75.86 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $151.36 | Professional | None | $81.28 | $81.28 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $64.57 Typical High $85.11 | Professional | None | $53.70 | $64.57 | $85.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $95.50 Typical High $128.82 | Professional | 50 · Both sides | $81.28 | $95.50 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $134.90 | Facility | None | $69.18 | $69.18 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $114.82 Typical High $194.98 | Facility | None | $66.07 | $114.82 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $91.20 Typical High $194.98 | Professional | None | $69.18 | $91.20 | $194.98 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $120.23 Median $302.00 Typical High $954.99 | Facility | None | $120.23 | $302.00 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $177.83 | Professional | None | $83.18 | $128.82 | $177.83 |
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 $60.26 Median $85.11 Typical High $144.54 | Professional | None | $60.26 | $85.11 | $144.54 |
4 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 $31.62 Median $39.81 Typical High $48.98 | Professional | 52 · Reduced service | $31.62 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $16.22 Typical High $19.50 | Professional | 53 · Discontinued | $12.59 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $12.02 Typical High $14.45 | Professional | 55 · Aftercare only | $9.33 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.94 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.31 | $7.94 | $9.77 |
Where Indiana sits
The same service costs 3.6 times more in Alaska 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
$81.28
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.