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 $151.36 Median $446.68 Typical High $5,623.41 | Facility | None | $151.36 | $446.68 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $263.03 | Professional | None | $112.20 | $204.17 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,890.45 Typical High $7,413.10 | Facility | None | $2,238.72 | $3,890.45 | $7,413.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $177.83 | Professional | None | $97.72 | $125.89 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $512.86 | Facility | None | $125.89 | $194.98 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $398.11 | Professional | None | $128.82 | $229.09 | $398.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $295.12 Median $707.95 Typical High $2,187.76 | Facility | None | $295.12 | $707.95 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $416.87 | Professional | None | $141.25 | $239.88 | $416.87 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,235.94 Typical High $4,466.84 | Facility | None | $1,905.46 | $3,235.94 | $4,466.84 |
United Setting Professional Modifier None Typical Low $120.23 Median $239.88 Typical High $426.58 | Professional | None | $120.23 | $239.88 | $426.58 |
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 $102.33 Typical High $128.82 | Professional | 52 · Reduced service | $56.23 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $40.74 Typical High $51.29 | Professional | 53 · Discontinued | $22.39 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $151.36 Typical High $194.98 | Professional | 54 · Surgery only | $85.11 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $30.20 Typical High $38.90 | Professional | 55 · Aftercare only | $16.98 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $20.42 Typical High $25.70 | Professional | 56 · Pre-op care only | $11.22 | $20.42 | $25.70 |
Where Indiana sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 48th of 51
$166
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.