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 $43.65 Median $141.25 Typical High $5,623.41 | Facility | None | $43.65 | $141.25 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $81.28 Typical High $114.82 | Professional | None | $40.74 | $81.28 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $128.82 | Professional | None | $81.28 | $81.28 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,073.80 Typical High $7,413.10 | Facility | None | $1,513.56 | $4,073.80 | $7,413.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $85.11 Typical High $229.09 | Professional | None | $36.31 | $85.11 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $120.23 | Professional | None | $79.43 | $89.13 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $112.20 Typical High $165.96 | Professional | None | $45.71 | $112.20 | $165.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $109.65 Median $257.04 Typical High $2,187.76 | Facility | None | $109.65 | $257.04 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $50.12 Median $102.33 Typical High $158.49 | Professional | None | $50.12 | $102.33 | $158.49 |
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 $42.66 Median $87.10 Typical High $151.36 | Professional | None | $42.66 | $87.10 | $151.36 |
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 $20.42 Median $40.74 Typical High $45.71 | Professional | 52 · Reduced service | $20.42 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $16.22 Typical High $18.20 | Professional | 53 · Discontinued | $8.13 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $61.66 Typical High $69.18 | Professional | 54 · Surgery only | $30.90 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $12.30 Typical High $13.80 | Professional | 55 · Aftercare only | $6.17 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $8.13 Typical High $9.12 | Professional | 56 · Pre-op care only | $4.07 | $8.13 | $9.12 |
Where Indiana sits
The same service costs 2.5 times more in North Carolina 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· 40th of 51
$87.10
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.