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 $131.83 Median $213.80 Typical High $5,495.41 | Facility | None | $131.83 | $213.80 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $186.21 | Professional | None | $120.23 | $154.88 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $158.49 | Professional | None | $102.33 | $120.23 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $190.55 | Facility | None | $134.90 | $134.90 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $177.83 Typical High $575.44 | Facility | None | $66.07 | $177.83 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $354.81 | Professional | None | $134.90 | $181.97 | $354.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $194.98 Median $524.81 Typical High $2,089.30 | Facility | None | $194.98 | $524.81 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $323.59 | Professional | None | $147.91 | $229.09 | $323.59 |
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 $120.23 Median $169.82 Typical High $275.42 | Professional | None | $120.23 | $169.82 | $275.42 |
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 $60.26 Median $77.62 Typical High $93.33 | Professional | 52 · Reduced service | $60.26 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.90 Typical High $37.15 | Professional | 53 · Discontinued | $23.99 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $117.49 Typical High $141.25 | Professional | 54 · Surgery only | $91.20 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $23.44 Typical High $28.18 | Professional | 55 · Aftercare only | $18.20 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.02 | $15.49 | $18.62 |
Where Indiana sits
The same service costs 3.6 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· 47th of 51
$162
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.