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 $31.62 Median $1,380.38 Typical High $5,011.87 | Facility | None | $31.62 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $38.90 Typical High $45.71 | Professional | None | $31.62 | $38.90 | $45.71 |
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 $27.54 Median $33.11 Typical High $46.77 | Professional | None | $27.54 | $33.11 | $46.77 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $41.69 Median $50.12 Typical High $70.79 | Professional | 50 · Both sides | $41.69 | $50.12 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $33.88 Median $616.60 Typical High $912.01 | Facility | None | $33.88 | $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 $26.92 Median $40.74 Typical High $79.43 | Professional | None | $26.92 | $40.74 | $79.43 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $79.43 Median $123.03 Typical High $2,089.30 | Facility | None | $79.43 | $123.03 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $38.90 Median $56.23 Typical High $75.86 | Professional | None | $38.90 | $56.23 | $75.86 |
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 $33.11 Median $42.66 Typical High $72.44 | Professional | None | $33.11 | $42.66 | $72.44 |
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 $15.85 Median $19.50 Typical High $22.91 | Professional | 52 · Reduced service | $15.85 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $7.76 Typical High $9.12 | Professional | 53 · Discontinued | $6.31 | $7.76 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $28.84 Typical High $34.67 | Professional | 54 · Surgery only | $23.99 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.89 Typical High $6.92 | Professional | 55 · Aftercare only | $4.79 | $5.89 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.89 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.16 | $3.89 | $4.57 |
Where Indiana sits
The same service costs 3.8 times more in Alaska than in Utah. 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· 40th of 51
$40.74
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.