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 $75.86 Median $75.86 Typical High $107.15 | Facility | None | $75.86 | $75.86 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $114.82 | Professional | None | $75.86 | $102.33 | $114.82 |
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 $74.13 Median $100.00 Typical High $131.83 | Professional | None | $74.13 | $100.00 | $131.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $151.36 Typical High $199.53 | Professional | 50 · Both sides | $112.20 | $151.36 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $162.18 | Facility | None | $89.13 | $89.13 | $162.18 |
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 $83.18 Median $114.82 Typical High $229.09 | Professional | None | $83.18 | $114.82 | $229.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $147.91 Median $346.74 Typical High $954.99 | Facility | None | $147.91 | $346.74 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $229.09 | Professional | None | $102.33 | $158.49 | $229.09 |
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 $72.44 Median $104.71 Typical High $177.83 | Professional | None | $72.44 | $104.71 | $177.83 |
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 $37.15 Median $51.29 Typical High $57.54 | Professional | 52 · Reduced service | $37.15 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $20.42 Typical High $22.91 | Professional | 53 · Discontinued | $15.14 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.49 Typical High $17.38 | Professional | 55 · Aftercare only | $11.22 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.23 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.59 | $10.23 | $11.48 |
Where Indiana sits
The same service costs 3.7 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· 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.