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 $120.23 Median $281.84 Typical High $5,011.87 | Facility | None | $120.23 | $281.84 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $275.42 | Professional | None | $109.65 | $204.17 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $190.55 | Professional | None | $120.23 | $120.23 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $4,073.80 Typical High $7,413.10 | Facility | None | $2,290.87 | $4,073.80 | $7,413.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $173.78 | Professional | None | $95.50 | $123.03 | $173.78 |
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 Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $389.05 | Professional | None | $125.89 | $213.80 | $389.05 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $288.40 Median $691.83 Typical High $2,187.76 | Facility | None | $288.40 | $691.83 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $407.38 | Professional | None | $138.04 | $239.88 | $407.38 |
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 $117.49 Median $234.42 Typical High $416.87 | Professional | None | $117.49 | $234.42 | $416.87 |
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 $54.95 Median $100.00 Typical High $125.89 | Professional | 52 · Reduced service | $54.95 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $39.81 Typical High $50.12 | Professional | 53 · Discontinued | $21.88 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $147.91 Typical High $190.55 | Professional | 54 · Surgery only | $83.18 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $29.51 Typical High $38.02 | Professional | 55 · Aftercare only | $16.60 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $19.95 Typical High $25.12 | Professional | 56 · Pre-op care only | $10.96 | $19.95 | $25.12 |
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· 49th of 51
$162
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.