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 $85.11 Median $3,467.37 Typical High $5,623.41 | Facility | None | $85.11 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $144.54 | Professional | None | $85.11 | $107.15 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $162.18 Typical High $239.88 | Professional | 50 · Both sides | $162.18 | $162.18 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $1,621.81 Typical High $5,248.07 | Facility | None | $70.79 | $1,621.81 | $5,248.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $158.49 Typical High $173.78 | Professional | None | $72.44 | $158.49 | $173.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $234.42 Typical High $275.42 | Professional | 50 · Both sides | $107.15 | $234.42 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $120.23 | Facility | None | $93.33 | $93.33 | $120.23 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | None | $102.33 | $102.33 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $128.82 Typical High $794.33 | Facility | None | $77.62 | $128.82 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $549.54 | Professional | None | $77.62 | $147.91 | $549.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $97.72 Median $229.09 Typical High $954.99 | Facility | None | $97.72 | $229.09 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $204.17 | Professional | None | $102.33 | $154.88 | $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 $93.33 Median $138.04 Typical High $229.09 | Professional | None | $93.33 | $138.04 | $229.09 |
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 $42.66 Median $52.48 Typical High $63.10 | Professional | 52 · Reduced service | $42.66 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $21.38 Typical High $25.12 | Professional | 53 · Discontinued | $16.98 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $79.43 Typical High $93.33 | Professional | 54 · Surgery only | $64.57 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.85 Typical High $18.62 | Professional | 55 · Aftercare only | $12.88 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.72 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.51 | $10.72 | $12.59 |
Where Indiana sits
The same service costs 3.7 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· 29th of 51
$145
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.