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 $15.85 Median $26.30 Typical High $36.31 | Facility | None | $15.85 | $26.30 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $26.30 Typical High $33.88 | Professional | None | $15.85 | $26.30 | $33.88 |
Ambetter Setting Professional Modifier None Typical Low $17.78 Median $25.12 Typical High $33.88 | Professional | None | $17.78 | $25.12 | $33.88 |
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 $14.79 Median $17.78 Typical High $27.54 | Professional | None | $14.79 | $17.78 | $27.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $21.88 Median $26.92 Typical High $41.69 | Professional | 50 · Both sides | $21.88 | $26.92 | $41.69 |
CareSource Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $28.84 | Facility | None | $18.20 | $18.20 | $28.84 |
CareSource Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $36.31 | Professional | None | $25.70 | $28.18 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $27.54 Typical High $66.07 | Facility | None | $16.60 | $27.54 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $36.31 Typical High $66.07 | Professional | None | $19.05 | $36.31 | $66.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $26.30 Median $47.86 Typical High $2,089.30 | Facility | None | $26.30 | $47.86 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $20.89 Median $35.48 Typical High $56.23 | Professional | None | $20.89 | $35.48 | $56.23 |
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 $15.85 Median $30.20 Typical High $50.12 | Professional | None | $15.85 | $30.20 | $50.12 |
5 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 $8.32 Median $11.48 Typical High $13.80 | Professional | 52 · Reduced service | $8.32 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $4.68 Typical High $5.50 | Professional | 53 · Discontinued | $3.31 | $4.68 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $3.47 Typical High $4.17 | Professional | 55 · Aftercare only | $2.51 | $3.47 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $2.29 Typical High $2.75 | Professional | 56 · Pre-op care only | $1.66 | $2.29 | $2.75 |
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | XS · Separate structure | $25.12 | $25.12 | $25.12 |
Where Indiana sits
The same service costs 3.0 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· 46th of 51
$26.30
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.