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 $18.20 Median $1,380.38 Typical High $5,011.87 | Facility | None | $18.20 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $20.89 Typical High $34.67 | Professional | None | $18.20 | $20.89 | $34.67 |
Ambetter Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $17.78 | Professional | None | $16.60 | $16.60 | $17.78 |
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 $18.20 Median $67.61 Typical High $77.62 | Professional | None | $18.20 | $67.61 | $77.62 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $26.92 Median $100.00 Typical High $123.03 | Professional | 50 · Both sides | $26.92 | $100.00 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $21.88 Median $616.60 Typical High $912.01 | Facility | None | $21.88 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $40.74 Typical High $120.23 | Professional | None | $22.91 | $40.74 | $120.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $53.70 Median $186.21 Typical High $2,089.30 | Facility | None | $53.70 | $186.21 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $22.39 Median $30.20 Typical High $40.74 | Professional | None | $22.39 | $30.20 | $40.74 |
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 $25.12 Median $39.81 Typical High $70.79 | Professional | None | $25.12 | $39.81 | $70.79 |
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 $9.12 Median $10.47 Typical High $12.02 | Professional | 52 · Reduced service | $9.12 | $10.47 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $4.17 Typical High $4.79 | Professional | 53 · Discontinued | $3.63 | $4.17 | $4.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.80 Median $15.49 Typical High $18.20 | Professional | 54 · Surgery only | $13.80 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.09 Typical High $3.63 | Professional | 55 · Aftercare only | $2.75 | $3.09 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.04 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.82 | $2.04 | $2.45 |
Where Indiana sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 13th of 51
$50.12
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.