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 $40.74 Median $3,801.89 Typical High $5,623.41 | Facility | None | $40.74 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $67.61 Typical High $87.10 | Professional | None | $40.74 | $67.61 | $87.10 |
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 $35.48 Median $83.18 Typical High $112.20 | Professional | None | $35.48 | $83.18 | $112.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $53.70 Median $123.03 Typical High $165.96 | Professional | 50 · Both sides | $53.70 | $123.03 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $100.00 | Facility | None | $44.67 | $44.67 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $93.33 Typical High $794.33 | Facility | None | $56.23 | $93.33 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $102.33 Typical High $295.12 | Professional | None | $47.86 | $102.33 | $295.12 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $75.86 Median $125.89 Typical High $2,089.30 | Facility | None | $75.86 | $125.89 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $47.86 Median $85.11 Typical High $154.88 | Professional | None | $47.86 | $85.11 | $154.88 |
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 $41.69 Median $85.11 Typical High $162.18 | Professional | None | $41.69 | $85.11 | $162.18 |
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 $19.95 Median $33.88 Typical High $39.81 | Professional | 52 · Reduced service | $19.95 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $13.49 Typical High $15.85 | Professional | 53 · Discontinued | $8.13 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $50.12 Typical High $58.88 | Professional | 54 · Surgery only | $30.20 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $10.00 Typical High $12.02 | Professional | 55 · Aftercare only | $6.03 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.76 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.07 | $6.76 | $7.94 |
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· 36th of 51
$83.18
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.