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 $64.57 Median $3,801.89 Typical High $5,623.41 | Facility | None | $64.57 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $102.33 Typical High $120.23 | Professional | None | $64.57 | $102.33 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $223.87 | Facility | None | $114.82 | $114.82 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $190.55 | Professional | None | $66.07 | $114.82 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $97.72 Typical High $537.03 | Facility | None | $70.79 | $97.72 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $120.23 Typical High $562.34 | Professional | None | $63.10 | $120.23 | $562.34 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $177.83 Median $331.13 Typical High $2,187.76 | Facility | None | $177.83 | $331.13 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $213.80 | Professional | None | $85.11 | $134.90 | $213.80 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $4,570.88 | Facility | None | $933.25 | $2,290.87 | $4,570.88 |
United Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $190.55 | Professional | None | $69.18 | $107.15 | $190.55 |
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 $32.36 Median $53.70 Typical High $60.26 | Professional | 52 · Reduced service | $32.36 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $21.88 Typical High $23.99 | Professional | 53 · Discontinued | $13.18 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $81.28 Typical High $89.13 | Professional | 54 · Surgery only | $48.98 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $16.22 Typical High $17.78 | Professional | 55 · Aftercare only | $9.77 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.96 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.46 | $10.96 | $12.02 |
Where Indiana sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 34th of 51
$115
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.