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 $112.20 Median $1,380.38 Typical High $5,011.87 | Facility | None | $112.20 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $162.18 | Professional | None | $112.20 | $138.04 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $102.33 Median $120.23 Typical High $181.97 | Professional | None | $102.33 | $120.23 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $134.90 | Facility | None | $128.82 | $128.82 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $173.78 | Facility | None | $66.07 | $102.33 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $275.42 | Professional | None | $128.82 | $169.82 | $275.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $114.82 Median $316.23 Typical High $2,089.30 | Facility | None | $114.82 | $316.23 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $263.03 | Professional | None | $128.82 | $177.83 | $263.03 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $263.03 | Professional | None | $123.03 | $169.82 | $263.03 |
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 $56.23 Median $69.18 Typical High $81.28 | Professional | 52 · Reduced service | $56.23 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $27.54 Typical High $33.11 | Professional | 53 · Discontinued | $22.39 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $102.33 Typical High $123.03 | Professional | 54 · Surgery only | $85.11 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $16.98 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.80 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.22 | $13.80 | $16.22 |
Where Indiana sits
The same service costs 2.9 times more in Alaska than in Kentucky. 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· 49th of 51
$155
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.