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 $107.15 Median $107.15 Typical High $138.04 | Facility | None | $107.15 | $107.15 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $144.54 | Professional | None | $102.33 | $123.03 | $144.54 |
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 $89.13 Median $109.65 Typical High $144.54 | Professional | None | $89.13 | $109.65 | $144.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $165.96 Typical High $223.87 | Professional | 50 · Both sides | $131.83 | $165.96 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $141.25 | Facility | None | $114.82 | $114.82 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $109.65 Typical High $186.21 | Facility | None | $66.07 | $109.65 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $275.42 | Professional | None | $117.49 | $151.36 | $275.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $131.83 Median $295.12 Typical High $954.99 | Facility | None | $131.83 | $295.12 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $275.42 | Professional | None | $117.49 | $190.55 | $275.42 |
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 $100.00 Median $138.04 Typical High $239.88 | Professional | None | $100.00 | $138.04 | $239.88 |
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 $52.48 Median $60.26 Typical High $72.44 | Professional | 52 · Reduced service | $52.48 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $23.99 Typical High $28.84 | Professional | 53 · Discontinued | $21.38 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $15.85 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.02 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.72 | $12.02 | $14.45 |
Where Indiana sits
The same service costs 4.3 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· 43rd of 51
$135
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.