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 $57.54 Median $81.28 Typical High $467.74 | Facility | None | $57.54 | $81.28 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $114.82 | Professional | None | $57.54 | $81.28 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $21.38 Median $75.86 Typical High $125.89 | Professional | None | $21.38 | $75.86 | $125.89 |
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 $50.12 Median $58.88 Typical High $79.43 | Professional | None | $50.12 | $58.88 | $79.43 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $74.13 Median $87.10 Typical High $117.49 | Professional | 50 · Both sides | $74.13 | $87.10 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $123.03 | Facility | None | $64.57 | $64.57 | $123.03 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $114.82 | Professional | None | $81.28 | $89.13 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $177.83 | Facility | None | $66.07 | $104.71 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $173.78 | Professional | None | $63.10 | $85.11 | $173.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $109.65 Median $275.42 Typical High $954.99 | Facility | None | $109.65 | $275.42 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $162.18 | Professional | None | $75.86 | $114.82 | $162.18 |
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 $53.70 Median $75.86 Typical High $131.83 | Professional | None | $53.70 | $75.86 | $131.83 |
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 $28.84 Median $36.31 Typical High $44.67 | Professional | 52 · Reduced service | $28.84 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.79 Typical High $17.78 | Professional | 53 · Discontinued | $11.48 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.96 Typical High $13.18 | Professional | 55 · Aftercare only | $8.71 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.24 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.75 | $7.24 | $8.91 |
Where Indiana sits
The same service costs 3.7 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· 49th 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.