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 $89.13 Median $1,380.38 Typical High $7,244.36 | Facility | None | $89.13 | $1,380.38 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $177.83 | Professional | None | $89.13 | $158.49 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $234.42 Typical High $323.59 | Professional | None | $93.33 | $234.42 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $2,884.03 | Facility | None | $91.20 | $91.20 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $1,737.80 Typical High $3,019.95 | Facility | None | $144.54 | $1,737.80 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $302.00 | Professional | None | $95.50 | $177.83 | $302.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $251.19 Median $2,511.89 Typical High $3,981.07 | Facility | None | $251.19 | $2,511.89 | $3,981.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $288.40 | Professional | None | $104.71 | $190.55 | $288.40 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $229.09 | Professional | None | $87.10 | $141.25 | $229.09 |
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 $44.67 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $44.67 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $31.62 Typical High $35.48 | Professional | 53 · Discontinued | $17.78 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $120.23 Typical High $134.90 | Professional | 54 · Surgery only | $66.07 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $13.18 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $8.91 | $15.85 | $17.78 |
Where Indiana sits
The same service costs 3.6 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· 18th of 51
$191
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.