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 $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $11.22 Typical High $12.02 | Professional | None | $10.96 | $11.22 | $12.02 |
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 $12.02 | Professional | None | $7.08 | $8.32 | $12.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $10.72 Median $12.59 Typical High $19.05 | Professional | 50 · Both sides | $10.72 | $12.59 | $19.05 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $4.47 Median $5.25 Typical High $7.59 | Professional | 62 · Two surgeons | $4.47 | $5.25 | $7.59 |
CareSource Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $602.56 Typical High $1,659.59 | Facility | None | $363.08 | $602.56 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $16.60 Typical High $120.23 | Professional | None | $12.59 | $16.60 | $120.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $31.62 Median $630.96 Typical High $2,089.30 | Facility | None | $31.62 | $630.96 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $12.02 Median $15.49 Typical High $23.44 | Professional | None | $12.02 | $15.49 | $23.44 |
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 $11.75 Median $14.79 Typical High $23.44 | Professional | None | $11.75 | $14.79 | $23.44 |
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 $5.50 Median $5.62 Typical High $6.03 | Professional | 52 · Reduced service | $5.50 | $5.62 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.24 Typical High $2.40 | Professional | 53 · Discontinued | $2.19 | $2.24 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.70 Typical High $1.82 | Professional | 55 · Aftercare only | $1.66 | $1.70 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.12 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.10 | $1.12 | $1.20 |
Where Indiana sits
The same service costs 12.3 times more in Florida 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
$14.13
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.