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 $251.19 Median $1,445.44 Typical High $5,248.07 | Facility | None | $251.19 | $1,445.44 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $977.24 Typical High $1,548.82 | Professional | None | $257.04 | $977.24 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $1,122.02 | Professional | None | $141.25 | $141.25 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $676.08 | Facility | None | $354.81 | $354.81 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $575.44 Typical High $1,288.25 | Professional | None | $223.87 | $575.44 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $851.14 Typical High $1,949.84 | Professional | 50 · Both sides | $331.13 | $851.14 | $1,949.84 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $436.52 Typical High $1,905.46 | Professional | None | $239.88 | $436.52 | $1,905.46 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $575.44 Median $954.99 Typical High $3,388.44 | Facility | None | $575.44 | $954.99 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $1,905.46 | Professional | None | $275.42 | $467.74 | $1,905.46 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $4,570.88 | Facility | None | $933.25 | $2,290.87 | $4,570.88 |
United Setting Professional Modifier None Typical Low $239.88 Median $691.83 Typical High $2,089.30 | Professional | None | $239.88 | $691.83 | $2,089.30 |
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 $131.83 Median $489.78 Typical High $741.31 | Professional | 52 · Reduced service | $131.83 | $489.78 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $194.98 Typical High $295.12 | Professional | 53 · Discontinued | $53.70 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $724.44 Typical High $1,096.48 | Professional | 54 · Surgery only | $199.53 | $724.44 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $144.54 Typical High $223.87 | Professional | 55 · Aftercare only | $39.81 | $144.54 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $97.72 Typical High $147.91 | Professional | 56 · Pre-op care only | $26.30 | $97.72 | $147.91 |
Where Indiana sits
The same service costs 5.8 times more in Washington than in Hawaii. 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
$562
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.