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 $389.05 Median $2,691.53 Typical High $5,011.87 | Facility | None | $389.05 | $2,691.53 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $1,548.82 Typical High $2,570.40 | Professional | None | $407.38 | $1,548.82 | $2,570.40 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $436.52 | Professional | None | $275.42 | $275.42 | $436.52 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $407.38 Typical High $660.69 | Professional | 50 · Both sides | $407.38 | $407.38 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $15,488.17 Typical High $25,703.96 | Facility | None | $7,244.36 | $15,488.17 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $1,348.96 Typical High $2,290.87 | Professional | None | $331.13 | $1,348.96 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $1,949.84 Typical High $3,467.37 | Professional | 50 · Both sides | $501.19 | $1,949.84 | $3,467.37 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,737.80 | $1,819.70 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $707.95 Typical High $2,818.38 | Professional | None | $363.08 | $707.95 | $2,818.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $891.25 Median $954.99 Typical High $6,606.93 | Facility | None | $891.25 | $954.99 | $6,606.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $436.52 Median $933.25 Typical High $3,630.78 | Professional | None | $436.52 | $933.25 | $3,630.78 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $11,220.18 Typical High $15,135.61 | Facility | None | $5,128.61 | $11,220.18 | $15,135.61 |
United Setting Professional Modifier None Typical Low $363.08 Median $1,659.59 Typical High $3,235.94 | Professional | None | $363.08 | $1,659.59 | $3,235.94 |
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 $204.17 Median $851.14 Typical High $1,174.90 | Professional | 52 · Reduced service | $204.17 | $851.14 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $338.84 Typical High $478.63 | Professional | 53 · Discontinued | $81.28 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $1,288.25 Typical High $1,778.28 | Professional | 54 · Surgery only | $302.00 | $1,288.25 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $257.04 Typical High $354.81 | Professional | 55 · Aftercare only | $60.26 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $169.82 Typical High $239.88 | Professional | 56 · Pre-op care only | $40.74 | $169.82 | $239.88 |
Where Indiana sits
The same service costs 6.3 times more in Washington 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· 36th of 51
$1,622
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.