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 $81.28 Median $3,467.37 Typical High $5,623.41 | Facility | None | $81.28 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $181.97 Typical High $208.93 | Professional | None | $81.28 | $181.97 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $194.98 | Professional | None | $72.44 | $125.89 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $2,884.03 | Facility | None | $87.10 | $87.10 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,862.09 Typical High $3,090.30 | Facility | None | $407.38 | $1,862.09 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $125.89 Typical High $302.00 | Professional | None | $67.61 | $125.89 | $302.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $234.42 Median $2,511.89 Typical High $3,981.07 | Facility | None | $234.42 | $2,511.89 | $3,981.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $331.13 | Professional | None | $95.50 | $173.78 | $331.13 |
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 $75.86 Median $144.54 Typical High $257.04 | Professional | None | $75.86 | $144.54 | $257.04 |
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 $39.81 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $39.81 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $16.22 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $60.26 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $12.02 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $8.13 | $18.20 | $20.89 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 33 · Preventive service | $83.18 | $83.18 | $83.18 |
Where Indiana sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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
$138
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.