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 $14.13 Median $15.49 Typical High $75.86 | Facility | None | $14.13 | $15.49 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $61.66 Typical High $77.62 | Professional | None | $15.14 | $61.66 | $77.62 |
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 $13.18 Median $19.95 Typical High $26.30 | Professional | None | $13.18 | $19.95 | $26.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $19.50 Median $30.20 Typical High $38.90 | Professional | 50 · Both sides | $19.50 | $30.20 | $38.90 |
CareSource Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $131.83 | Facility | None | $16.22 | $16.22 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $524.81 | Facility | None | $66.07 | $107.15 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $75.86 Typical High $125.89 | Professional | None | $16.98 | $75.86 | $125.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $41.69 Median $144.54 Typical High $229.09 | Facility | None | $41.69 | $144.54 | $229.09 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $162.18 | Professional | None | $38.90 | $39.81 | $162.18 |
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 $14.13 Median $54.95 Typical High $123.03 | Professional | None | $14.13 | $54.95 | $123.03 |
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 $7.59 Median $30.20 Typical High $38.90 | Professional | 52 · Reduced service | $7.59 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $12.30 Typical High $15.49 | Professional | 53 · Discontinued | $3.02 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $9.12 Typical High $11.75 | Professional | 55 · Aftercare only | $2.24 | $9.12 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $6.17 Typical High $7.76 | Professional | 56 · Pre-op care only | $1.51 | $6.17 | $7.76 |
Where Indiana sits
The same service costs 5.9 times more in Iowa 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· 49th of 51
$23.99
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.