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 $41.69 Median $41.69 Typical High $58.88 | Facility | None | $41.69 | $41.69 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $53.70 Typical High $63.10 | Professional | None | $41.69 | $53.70 | $63.10 |
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 $36.31 Median $63.10 Typical High $75.86 | Professional | None | $36.31 | $63.10 | $75.86 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $74.13 | Facility | None | $45.71 | $45.71 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $66.07 Typical High $114.82 | Facility | None | $44.67 | $66.07 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $114.82 | Professional | None | $45.71 | $64.57 | $114.82 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $70.79 Median $177.83 Typical High $954.99 | Facility | None | $70.79 | $177.83 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $46.77 Median $81.28 Typical High $120.23 | Professional | None | $46.77 | $81.28 | $120.23 |
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 $38.02 Median $57.54 Typical High $97.72 | Professional | None | $38.02 | $57.54 | $97.72 |
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 $20.42 Median $26.92 Typical High $31.62 | Professional | 52 · Reduced service | $20.42 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.72 Typical High $12.59 | Professional | 53 · Discontinued | $8.32 | $10.72 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.94 Typical High $9.55 | Professional | 55 · Aftercare only | $6.17 | $7.94 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.37 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.07 | $5.37 | $6.31 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 58 · Staged procedure | $36.31 | $36.31 | $36.31 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 36th of 51
$63.10
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.