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 $112.20 Typical High $5,623.41 | Facility | None | $51.29 | $112.20 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $104.71 | Professional | None | $47.86 | $69.18 | $104.71 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $48.98 Median $67.61 Typical High $107.15 | Professional | 50 · Both sides | $48.98 | $67.61 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $6,165.95 | Facility | None | $616.60 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $70.79 | Professional | None | $41.69 | $50.12 | $70.79 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $63.10 Median $74.13 Typical High $112.20 | Professional | 50 · Both sides | $63.10 | $74.13 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $74.13 | Facility | None | $53.70 | $53.70 | $74.13 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $95.50 | Professional | None | $67.61 | $74.13 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $81.28 Typical High $794.33 | Facility | None | $50.12 | $81.28 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $213.80 | Professional | None | $58.88 | $97.72 | $213.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $63.10 Median $138.04 Typical High $954.99 | Facility | None | $63.10 | $138.04 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $54.95 Median $89.13 Typical High $134.90 | Professional | None | $54.95 | $89.13 | $134.90 |
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 $50.12 Median $77.62 Typical High $125.89 | Professional | None | $50.12 | $77.62 | $125.89 |
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 $23.99 Median $32.36 Typical High $38.02 | Professional | 52 · Reduced service | $23.99 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $12.88 Typical High $15.14 | Professional | 53 · Discontinued | $9.55 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $48.98 Typical High $57.54 | Professional | 54 · Surgery only | $36.31 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.77 Typical High $11.48 | Professional | 55 · Aftercare only | $7.24 | $9.77 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.46 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.79 | $6.46 | $7.59 |
Where Indiana sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$69.18
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.