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 $2,344.23 Typical High $5,623.41 | Facility | None | $51.29 | $2,344.23 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $93.33 Typical High $114.82 | Professional | None | $51.29 | $93.33 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | None | $107.15 | $125.89 | $125.89 |
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 $46.77 Median $91.20 Typical High $120.23 | Professional | None | $46.77 | $91.20 | $120.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $70.79 Median $138.04 Typical High $181.97 | Professional | 50 · Both sides | $70.79 | $138.04 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $144.54 | Facility | None | $56.23 | $56.23 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $169.82 Typical High $794.33 | Facility | None | $102.33 | $169.82 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $120.23 Typical High $275.42 | Professional | None | $60.26 | $120.23 | $275.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $2,089.30 | Facility | None | $131.83 | $213.80 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $60.26 Median $114.82 Typical High $213.80 | Professional | None | $60.26 | $114.82 | $213.80 |
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 $52.48 Median $104.71 Typical High $177.83 | Professional | None | $52.48 | $104.71 | $177.83 |
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 $25.70 Median $44.67 Typical High $53.70 | Professional | 52 · Reduced service | $25.70 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $17.78 Typical High $21.38 | Professional | 53 · Discontinued | $10.23 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $66.07 Typical High $79.43 | Professional | 54 · Surgery only | $38.90 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $13.18 Typical High $15.85 | Professional | 55 · Aftercare only | $7.76 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.91 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.13 | $8.91 | $10.72 |
Where Indiana sits
The same service costs 3.2 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· 44th of 51
$102
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.