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 $51.29 Median $120.23 Typical High $5,011.87 | Facility | None | $51.29 | $120.23 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $128.82 | Professional | None | $48.98 | $77.62 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $91.20 Typical High $125.89 | Professional | None | $25.12 | $91.20 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,090.30 Typical High $6,165.95 | Facility | None | $616.60 | $3,090.30 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $83.18 Typical High $138.04 | Professional | None | $43.65 | $83.18 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $1,862.09 Typical High $2,754.23 | Facility | None | $52.48 | $1,862.09 | $2,754.23 |
CareSource Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $134.90 | Professional | None | $95.50 | $112.20 | $134.90 |
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 $56.23 Median $93.33 Typical High $158.49 | Professional | None | $56.23 | $93.33 | $158.49 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $125.89 Median $295.12 Typical High $2,187.76 | Facility | None | $125.89 | $295.12 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $52.48 Median $102.33 Typical High $162.18 | Professional | None | $52.48 | $102.33 | $162.18 |
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 $51.29 Median $83.18 Typical High $151.36 | Professional | None | $51.29 | $83.18 | $151.36 |
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 $24.55 Median $44.67 Typical High $54.95 | Professional | 52 · Reduced service | $24.55 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $17.78 Typical High $21.88 | Professional | 53 · Discontinued | $9.77 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $67.61 Typical High $81.28 | Professional | 54 · Surgery only | $36.31 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $13.49 Typical High $16.22 | Professional | 55 · Aftercare only | $7.24 | $13.49 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $8.91 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.90 | $8.91 | $10.96 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $54.95 Typical High $144.54 | Professional | 51 · Multiple procedures | $26.92 | $54.95 | $144.54 |
Where Indiana sits
The same service costs 3.2 times more in Alaska than in New York. 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· 32nd of 51
$97.72
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.