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 $112.20 | Facility | None | $75.86 | $75.86 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $123.03 | Professional | None | $75.86 | $102.33 | $123.03 |
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 $61.66 Median $72.44 Typical High $102.33 | Professional | None | $61.66 | $72.44 | $102.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $109.65 Typical High $154.88 | Professional | 50 · Both sides | $93.33 | $109.65 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $147.91 | Facility | None | $85.11 | $85.11 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $128.82 Typical High $234.42 | Facility | None | $66.07 | $128.82 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $234.42 | Professional | None | $85.11 | $120.23 | $234.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $131.83 Median $338.84 Typical High $954.99 | Facility | None | $131.83 | $338.84 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $87.10 Median $158.49 Typical High $239.88 | Professional | None | $87.10 | $158.49 | $239.88 |
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 $74.13 Median $109.65 Typical High $186.21 | Professional | None | $74.13 | $109.65 | $186.21 |
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 $38.02 Median $51.29 Typical High $61.66 | Professional | 52 · Reduced service | $38.02 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $20.42 Typical High $24.55 | Professional | 53 · Discontinued | $15.14 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.49 Typical High $18.62 | Professional | 55 · Aftercare only | $11.22 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.59 | $10.23 | $12.30 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 47th of 51
$100
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.