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 $17.38 Median $17.38 Typical High $33.11 | Facility | None | $17.38 | $17.38 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $27.54 Typical High $33.11 | Professional | None | $17.38 | $27.54 | $33.11 |
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 $15.14 Median $19.05 Typical High $30.20 | Professional | None | $15.14 | $19.05 | $30.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $22.39 Median $28.18 Typical High $44.67 | Professional | 50 · Both sides | $22.39 | $28.18 | $44.67 |
CareSource Setting Facility Modifier None Typical Low $19.05 Median $616.60 Typical High $912.01 | Facility | None | $19.05 | $616.60 | $912.01 |
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 $19.95 Median $42.66 Typical High $95.50 | Professional | None | $19.95 | $42.66 | $95.50 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $45.71 Median $416.87 Typical High $2,137.96 | Facility | None | $45.71 | $416.87 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $20.89 Median $39.81 Typical High $70.79 | Professional | None | $20.89 | $39.81 | $70.79 |
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 $17.38 Median $35.48 Typical High $61.66 | Professional | None | $17.38 | $35.48 | $61.66 |
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 $8.71 Median $13.80 Typical High $16.60 | Professional | 52 · Reduced service | $8.71 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $5.50 Typical High $6.61 | Professional | 53 · Discontinued | $3.47 | $5.50 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $4.17 Typical High $5.01 | Professional | 55 · Aftercare only | $2.63 | $4.17 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $2.75 Typical High $3.31 | Professional | 56 · Pre-op care only | $1.74 | $2.75 | $3.31 |
Where Indiana sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 44th of 51
$33.11
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.