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 $79.43 Median $147.91 Typical High $5,495.41 | Facility | None | $79.43 | $147.91 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $123.03 | Professional | None | $74.13 | $102.33 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $128.82 Typical High $1,071.52 | Facility | None | $72.44 | $128.82 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $97.72 | Professional | None | $61.66 | $72.44 | $97.72 |
CareSource Setting Facility Modifier None Typical Low $83.18 Median $831.76 Typical High $1,230.27 | Facility | None | $83.18 | $831.76 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $2,691.53 | Facility | None | $501.19 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $213.80 | Professional | None | $83.18 | $123.03 | $213.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $2,137.96 | Facility | None | $204.17 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $204.17 | Professional | None | $87.10 | $141.25 | $204.17 |
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 $72.44 Median $109.65 Typical High $186.21 | Professional | None | $72.44 | $109.65 | $186.21 |
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 $37.15 Median $51.29 Typical High $60.26 | Professional | 52 · Reduced service | $37.15 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.42 Typical High $24.55 | Professional | 53 · Discontinued | $14.79 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $77.62 Typical High $91.20 | Professional | 54 · Surgery only | $56.23 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.49 Typical High $18.20 | Professional | 55 · Aftercare only | $11.22 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.41 | $10.23 | $12.30 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$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.