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 $15.49 Median $28.18 Typical High $42.66 | Facility | None | $15.49 | $28.18 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $26.92 Typical High $33.88 | Professional | None | $16.60 | $26.92 | $33.88 |
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 $12.59 Median $29.51 Typical High $40.74 | Professional | None | $12.59 | $29.51 | $40.74 |
CareSource Setting Facility Modifier None Typical Low $14.45 Median $16.98 Typical High $912.01 | Facility | None | $14.45 | $16.98 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $25.12 Median $28.84 Typical High $35.48 | Professional | None | $25.12 | $28.84 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $109.65 Typical High $524.81 | Facility | None | $50.12 | $109.65 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $30.90 Typical High $48.98 | Professional | None | $16.60 | $30.90 | $48.98 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $38.02 Median $186.21 Typical High $2,089.30 | Facility | None | $38.02 | $186.21 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $17.78 Median $30.20 Typical High $43.65 | Professional | None | $17.78 | $30.20 | $43.65 |
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 $15.85 Median $29.51 Typical High $53.70 | Professional | None | $15.85 | $29.51 | $53.70 |
6 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 $8.51 Median $13.49 Typical High $16.98 | Professional | 52 · Reduced service | $8.51 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $5.37 Typical High $6.76 | Professional | 53 · Discontinued | $3.39 | $5.37 | $6.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.88 Median $20.42 Typical High $25.12 | Professional | 54 · Surgery only | $12.88 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $4.07 Typical High $5.01 | Professional | 55 · Aftercare only | $2.51 | $4.07 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $2.69 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.70 | $2.69 | $3.39 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | GC · Resident with teaching physician | $19.95 | $19.95 | $19.95 |
Where Indiana sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 39th of 51
$30.20
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.