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 $41.69 Median $3,801.89 Typical High $5,623.41 | Facility | None | $41.69 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $69.18 Typical High $79.43 | Professional | None | $41.69 | $69.18 | $79.43 |
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 $36.31 Median $114.82 Typical High $138.04 | Professional | None | $36.31 | $114.82 | $138.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $53.70 Median $169.82 Typical High $213.80 | Professional | 50 · Both sides | $53.70 | $169.82 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $104.71 | Facility | None | $45.71 | $45.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $102.33 Typical High $602.56 | Facility | None | $60.26 | $102.33 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $100.00 Typical High $239.88 | Professional | None | $48.98 | $100.00 | $239.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $954.99 | Facility | None | $79.43 | $131.83 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $48.98 Median $89.13 Typical High $158.49 | Professional | None | $48.98 | $89.13 | $158.49 |
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 $41.69 Median $85.11 Typical High $134.90 | Professional | None | $41.69 | $85.11 | $134.90 |
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 $20.89 Median $33.88 Typical High $39.81 | Professional | 52 · Reduced service | $20.89 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $13.80 Typical High $15.85 | Professional | 53 · Discontinued | $8.32 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $51.29 Typical High $60.26 | Professional | 54 · Surgery only | $31.62 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $10.23 Typical High $12.02 | Professional | 55 · Aftercare only | $6.31 | $10.23 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.92 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.17 | $6.92 | $7.94 |
Where Indiana sits
The same service costs 3.0 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· 28th of 51
$97.72
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.