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 $60.26 Median $1,380.38 Typical High $5,011.87 | Facility | None | $60.26 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $85.11 | Professional | None | $60.26 | $72.44 | $85.11 |
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 $44.67 Median $52.48 Typical High $79.43 | Professional | None | $44.67 | $52.48 | $79.43 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $67.61 Median $79.43 Typical High $120.23 | Professional | 50 · Both sides | $67.61 | $79.43 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $67.61 | Facility | None | $66.07 | $66.07 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $100.00 | Facility | None | $43.65 | $66.07 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $72.44 Typical High $128.82 | Professional | None | $48.98 | $72.44 | $128.82 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $57.54 Median $169.82 Typical High $977.24 | Facility | None | $57.54 | $169.82 | $977.24 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $141.25 | Professional | None | $74.13 | $107.15 | $141.25 |
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 $58.88 Median $79.43 Typical High $134.90 | Professional | None | $58.88 | $79.43 | $134.90 |
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 $30.20 Median $36.31 Typical High $42.66 | Professional | 52 · Reduced service | $30.20 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $14.45 Typical High $16.98 | Professional | 53 · Discontinued | $12.02 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $53.70 Typical High $64.57 | Professional | 54 · Surgery only | $44.67 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.72 Typical High $12.88 | Professional | 55 · Aftercare only | $9.12 | $10.72 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.24 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.03 | $7.24 | $8.51 |
Where Indiana sits
The same service costs 3.8 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· 46th of 51
$72.44
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.