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 $45.71 Median $1,380.38 Typical High $5,011.87 | Facility | None | $45.71 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $74.13 | Professional | None | $45.71 | $63.10 | $74.13 |
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 $41.69 Median $48.98 Typical High $64.57 | Professional | None | $41.69 | $48.98 | $64.57 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $48.98 Median $74.13 Typical High $97.72 | Professional | 50 · Both sides | $48.98 | $74.13 | $97.72 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $117.49 | Facility | None | $50.12 | $50.12 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $93.33 Typical High $158.49 | Facility | None | $64.57 | $93.33 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $144.54 | Professional | None | $50.12 | $66.07 | $144.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $104.71 Median $229.09 Typical High $954.99 | Facility | None | $104.71 | $229.09 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $147.91 | Professional | None | $60.26 | $95.50 | $147.91 |
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 $43.65 Median $66.07 Typical High $114.82 | Professional | None | $43.65 | $66.07 | $114.82 |
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 $22.91 Median $31.62 Typical High $37.15 | Professional | 52 · Reduced service | $22.91 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $12.88 Typical High $14.79 | Professional | 53 · Discontinued | $9.33 | $12.88 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $47.86 Typical High $56.23 | Professional | 54 · Surgery only | $34.67 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $9.55 Typical High $11.22 | Professional | 55 · Aftercare only | $6.92 | $9.55 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.31 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.57 | $6.31 | $7.41 |
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
$61.66
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.