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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $81.28 | Professional | None | $74.13 | $74.13 | $81.28 |
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 $7.08 Median $8.32 Typical High $69.18 | Professional | None | $7.08 | $8.32 | $69.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $10.72 Median $12.59 Typical High $104.71 | Professional | 50 · Both sides | $10.72 | $12.59 | $104.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $5.25 Median $6.76 Typical High $43.65 | Professional | 62 · Two surgeons | $5.25 | $6.76 | $43.65 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $363.08 Typical High $1,659.59 | Facility | None | $83.18 | $363.08 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $120.23 | Professional | None | $75.86 | $93.33 | $120.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $213.80 Median $630.96 Typical High $2,089.30 | Facility | None | $213.80 | $630.96 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $154.88 | Professional | None | $79.43 | $102.33 | $154.88 |
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 $75.86 Median $95.50 Typical High $158.49 | Professional | None | $75.86 | $95.50 | $158.49 |
4 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 $37.15 Median $37.15 Typical High $39.81 | Professional | 52 · Reduced service | $37.15 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $16.22 | Professional | 53 · Discontinued | $14.79 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.22 Typical High $12.02 | Professional | 55 · Aftercare only | $10.96 | $11.22 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.94 |
Where Indiana sits
The same service costs 4.5 times more in Alaska 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· 46th of 51
$87.10
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.