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 $58.88 Median $5,011.87 Typical High $5,623.41 | Facility | None | $58.88 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $70.79 | Professional | None | $53.70 | $58.88 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $1,905.46 Typical High $5,370.32 | Facility | None | $257.04 | $1,905.46 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $83.18 Typical High $87.10 | Professional | None | $40.74 | $83.18 | $87.10 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $489.78 | Facility | None | $50.12 | $50.12 | $489.78 |
CareSource Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $446.68 Typical High $812.83 | Facility | None | $295.12 | $446.68 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $120.23 | Professional | None | $51.29 | $61.66 | $120.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $134.90 Median $588.84 Typical High $1,412.54 | Facility | None | $134.90 | $588.84 | $1,412.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $91.20 | Professional | None | $50.12 | $67.61 | $91.20 |
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 $43.65 Median $57.54 Typical High $95.50 | Professional | None | $43.65 | $57.54 | $95.50 |
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 $26.92 Median $29.51 Typical High $34.67 | Professional | 52 · Reduced service | $26.92 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $11.75 Typical High $13.80 | Professional | 53 · Discontinued | $10.72 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $44.67 Typical High $52.48 | Professional | 54 · Surgery only | $39.81 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.91 Typical High $10.23 | Professional | 55 · Aftercare only | $7.94 | $8.91 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.89 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.37 | $5.89 | $6.92 |
Where Indiana sits
The same service costs 4.2 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· 25th of 51
$70.79
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.