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 $11.75 Median $14.79 Typical High $52.48 | Facility | None | $11.75 | $14.79 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $14.45 Typical High $17.38 | Professional | None | $11.75 | $14.45 | $17.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $19.05 Typical High $38.90 | Professional | None | $11.48 | $19.05 | $38.90 |
CareSource Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $7.24 Median $12.02 Typical High $794.33 | Facility | None | $7.24 | $12.02 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $18.62 Typical High $42.66 | Professional | None | $13.18 | $18.62 | $42.66 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $11.22 Median $31.62 Typical High $954.99 | Facility | None | $11.22 | $31.62 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $12.30 Median $16.98 Typical High $25.12 | Professional | None | $12.30 | $16.98 | $25.12 |
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 $12.30 Median $18.20 Typical High $29.51 | Professional | None | $12.30 | $18.20 | $29.51 |
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 $5.89 Median $6.61 Typical High $7.41 | Professional | 52 · Reduced service | $5.89 | $6.61 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.69 Typical High $3.02 | Professional | 53 · Discontinued | $2.34 | $2.69 | $3.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $10.00 Typical High $11.22 | Professional | 54 · Surgery only | $8.91 | $10.00 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $2.00 Typical High $2.24 | Professional | 55 · Aftercare only | $1.78 | $2.00 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.32 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.17 | $1.32 | $1.51 |
Where Indiana sits
The same service costs 3.5 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· 33rd of 51
$19.05
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.