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 $52.48 Median $3,801.89 Typical High $5,623.41 | Facility | None | $52.48 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $91.20 | Professional | None | $52.48 | $74.13 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
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 $45.71 Median $54.95 Typical High $77.62 | Professional | None | $45.71 | $54.95 | $77.62 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $67.61 Median $83.18 Typical High $117.49 | Professional | 50 · Both sides | $67.61 | $83.18 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $91.20 | Facility | None | $57.54 | $57.54 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $100.00 Typical High $724.44 | Facility | None | $58.88 | $100.00 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $104.71 Typical High $295.12 | Professional | None | $61.66 | $104.71 | $295.12 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $77.62 Median $144.54 Typical High $2,089.30 | Facility | None | $77.62 | $144.54 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $158.49 | Professional | None | $60.26 | $100.00 | $158.49 |
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 $53.70 Median $85.11 Typical High $158.49 | Professional | None | $53.70 | $85.11 | $158.49 |
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 $26.30 Median $37.15 Typical High $42.66 | Professional | 52 · Reduced service | $26.30 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $14.79 Typical High $16.98 | Professional | 53 · Discontinued | $10.47 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $54.95 Typical High $63.10 | Professional | 54 · Surgery only | $39.81 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.96 Typical High $12.59 | Professional | 55 · Aftercare only | $7.94 | $10.96 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.41 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.25 | $7.41 | $8.51 |
Where Indiana sits
The same service costs 3.2 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· 48th of 51
$77.62
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.