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 $120.23 Median $1,380.38 Typical High $5,623.41 | Facility | None | $120.23 | $1,380.38 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $165.96 | Professional | None | $117.49 | $120.23 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $93.33 | Professional | None | $58.88 | $70.79 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $1,348.96 | Facility | None | $123.03 | $123.03 | $1,348.96 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $870.96 Typical High $1,862.09 | Facility | None | $177.83 | $870.96 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $218.78 | Professional | None | $114.82 | $131.83 | $218.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $1,659.59 Typical High $3,548.13 | Facility | None | $954.99 | $1,659.59 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $239.88 | Professional | None | $85.11 | $125.89 | $239.88 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $194.98 | Professional | None | $104.71 | $128.82 | $194.98 |
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 $58.88 Median $60.26 Typical High $79.43 | Professional | 52 · Reduced service | $58.88 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.99 Typical High $31.62 | Professional | 53 · Discontinued | $23.44 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $89.13 Typical High $117.49 | Professional | 54 · Surgery only | $87.10 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $23.44 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.02 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.75 | $12.02 | $15.85 |
Where Indiana sits
The same service costs 6.0 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
$117
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.