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 $41.69 Median $66.07 Typical High $128.82 | Facility | None | $41.69 | $66.07 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $69.18 Typical High $104.71 | Professional | None | $38.90 | $69.18 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $125.89 | Professional | None | $85.11 | $107.15 | $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 $34.67 Median $77.62 Typical High $95.50 | Professional | None | $34.67 | $77.62 | $95.50 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $51.29 Median $117.49 Typical High $144.54 | Professional | 50 · Both sides | $51.29 | $117.49 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $107.15 | Facility | None | $42.66 | $42.66 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $107.15 | Professional | None | $75.86 | $83.18 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $173.78 | Facility | None | $66.07 | $100.00 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $83.18 Typical High $177.83 | Professional | None | $48.98 | $83.18 | $177.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $97.72 Median $165.96 Typical High $2,089.30 | Facility | None | $97.72 | $165.96 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $48.98 Median $93.33 Typical High $147.91 | Professional | None | $48.98 | $93.33 | $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 $38.90 Median $70.79 Typical High $125.89 | Professional | None | $38.90 | $70.79 | $125.89 |
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 $19.50 Median $34.67 Typical High $41.69 | Professional | 52 · Reduced service | $19.50 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $13.80 Typical High $16.60 | Professional | 53 · Discontinued | $7.76 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.23 Typical High $12.59 | Professional | 55 · Aftercare only | $5.75 | $10.23 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.92 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.89 | $6.92 | $8.32 |
Where Indiana sits
The same service costs 3.8 times more in Alaska 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· 42nd of 51
$77.62
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.