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 $42.66 Median $83.18 Typical High $5,011.87 | Facility | None | $42.66 | $83.18 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $66.07 Typical High $95.50 | Professional | None | $38.02 | $66.07 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $51.29 Typical High $60.26 | Professional | None | $25.12 | $51.29 | $60.26 |
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 $81.28 Typical High $100.00 | Professional | None | $36.31 | $81.28 | $100.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $54.95 Median $123.03 Typical High $151.36 | Professional | 50 · Both sides | $54.95 | $123.03 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $93.33 | Facility | None | $42.66 | $42.66 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $93.33 | Professional | None | $66.07 | $74.13 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $794.33 | Facility | None | $66.07 | $107.15 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $93.33 Typical High $190.55 | Professional | None | $46.77 | $93.33 | $190.55 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $83.18 Median $138.04 Typical High $2,089.30 | Facility | None | $83.18 | $138.04 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $45.71 Median $83.18 Typical High $141.25 | Professional | None | $45.71 | $83.18 | $141.25 |
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 $38.90 Median $74.13 Typical High $125.89 | Professional | None | $38.90 | $74.13 | $125.89 |
6 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 $19.50 Median $29.51 Typical High $36.31 | Professional | 52 · Reduced service | $19.50 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $12.02 Typical High $14.45 | Professional | 53 · Discontinued | $7.94 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $44.67 Typical High $53.70 | Professional | 54 · Surgery only | $29.51 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $8.91 Typical High $10.96 | Professional | 55 · Aftercare only | $5.89 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.89 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.98 | $5.89 | $7.24 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 59 · Distinct service | $33.88 | $33.88 | $33.88 |
Where Indiana sits
The same service costs 3.5 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· 38th of 51
$75.86
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.