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 $81.28 Median $81.28 Typical High $114.82 | Facility | None | $81.28 | $81.28 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $123.03 | Professional | None | $81.28 | $102.33 | $123.03 |
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 $69.18 Median $83.18 Typical High $109.65 | Professional | None | $69.18 | $83.18 | $109.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $123.03 Typical High $165.96 | Professional | 50 · Both sides | $104.71 | $123.03 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $165.96 | Facility | None | $89.13 | $89.13 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $134.90 Typical High $245.47 | Facility | None | $66.07 | $134.90 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $234.42 | Professional | None | $89.13 | $120.23 | $234.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $147.91 Median $371.54 Typical High $954.99 | Facility | None | $147.91 | $371.54 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $239.88 | Professional | None | $104.71 | $162.18 | $239.88 |
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 $75.86 Median $109.65 Typical High $186.21 | Professional | None | $75.86 | $109.65 | $186.21 |
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 $39.81 Median $51.29 Typical High $61.66 | Professional | 52 · Reduced service | $39.81 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $20.42 Typical High $25.12 | Professional | 53 · Discontinued | $16.22 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.49 Typical High $18.62 | Professional | 55 · Aftercare only | $12.02 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.94 | $10.23 | $12.30 |
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· 46th of 51
$105
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.