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 $42.66 Median $70.79 Typical High $114.82 | Facility | None | $42.66 | $70.79 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $60.26 Typical High $87.10 | Professional | None | $37.15 | $60.26 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $87.10 | Professional | None | $53.70 | $58.88 | $87.10 |
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 $38.02 Median $64.57 Typical High $77.62 | Professional | None | $38.02 | $64.57 | $77.62 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $57.54 Median $95.50 Typical High $120.23 | Professional | 50 · Both sides | $57.54 | $95.50 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $40.74 Median $616.60 Typical High $912.01 | Facility | None | $40.74 | $616.60 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $87.10 | Professional | None | $61.66 | $67.61 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $128.82 | Professional | None | $40.74 | $66.07 | $128.82 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $2,089.30 | Facility | None | $114.82 | $251.19 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $120.23 | Professional | None | $50.12 | $85.11 | $120.23 |
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 $34.67 Median $56.23 Typical High $97.72 | Professional | None | $34.67 | $56.23 | $97.72 |
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 $18.62 Median $27.54 Typical High $33.11 | Professional | 52 · Reduced service | $18.62 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $10.96 Typical High $13.18 | Professional | 53 · Discontinued | $7.41 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $8.32 Typical High $10.00 | Professional | 55 · Aftercare only | $5.62 | $8.32 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.50 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.72 | $5.50 | $6.61 |
Where Indiana sits
The same service costs 4.0 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· 34th of 51
$64.57
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.