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 $50.12 Median $77.62 Typical High $144.54 | Facility | None | $50.12 | $77.62 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $87.10 | Professional | None | $50.12 | $70.79 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $112.20 | Professional | None | $72.44 | $72.44 | $112.20 |
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 $45.71 Median $53.70 Typical High $75.86 | Professional | None | $45.71 | $53.70 | $75.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $67.61 Median $79.43 Typical High $114.82 | Professional | 50 · Both sides | $67.61 | $79.43 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $95.50 | Facility | None | $54.95 | $54.95 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $79.43 Typical High $134.90 | Facility | None | $56.23 | $79.43 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $169.82 | Professional | None | $58.88 | $91.20 | $169.82 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $87.10 Median $229.09 Typical High $954.99 | Facility | None | $87.10 | $229.09 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $144.54 | Professional | None | $67.61 | $102.33 | $144.54 |
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 $50.12 Median $74.13 Typical High $128.82 | Professional | None | $50.12 | $74.13 | $128.82 |
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 $25.12 Median $31.62 Typical High $37.15 | Professional | 52 · Reduced service | $25.12 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $12.59 Typical High $14.79 | Professional | 53 · Discontinued | $10.23 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $9.33 Typical High $10.96 | Professional | 55 · Aftercare only | $7.59 | $9.33 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.31 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.01 | $6.31 | $7.41 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 45th of 51
$72.44
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.