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 $61.66 Median $199.53 Typical High $5,623.41 | Facility | None | $61.66 | $199.53 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $81.28 Typical High $138.04 | Professional | None | $39.81 | $81.28 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $165.96 | Professional | None | $93.33 | $151.36 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $3,162.28 Typical High $6,309.57 | Facility | None | $549.54 | $3,162.28 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $60.26 Typical High $123.03 | Professional | None | $33.11 | $60.26 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $41.69 Median $616.60 Typical High $912.01 | Facility | None | $41.69 | $616.60 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $147.91 | Professional | None | $100.00 | $112.20 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $64.57 Typical High $165.96 | Professional | None | $38.02 | $64.57 | $165.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $112.20 Median $309.03 Typical High $2,089.30 | Facility | None | $112.20 | $309.03 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $190.55 | Professional | None | $51.29 | $85.11 | $190.55 |
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 $36.31 Median $75.86 Typical High $128.82 | Professional | None | $36.31 | $75.86 | $128.82 |
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 $19.95 Median $41.69 Typical High $60.26 | Professional | 52 · Reduced service | $19.95 | $41.69 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $16.60 Typical High $23.99 | Professional | 53 · Discontinued | $7.94 | $16.60 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $61.66 Typical High $89.13 | Professional | 54 · Surgery only | $30.20 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $13.80 Typical High $17.78 | Professional | 55 · Aftercare only | $6.03 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $9.33 Typical High $12.02 | Professional | 56 · Pre-op care only | $3.98 | $9.33 | $12.02 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 79 · Unrelated procedure after surgery | $102.33 | $102.33 | $102.33 |
Where Indiana sits
The same service costs 3.4 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· 38th of 51
$81.28
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.