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 $44.67 Median $107.15 Typical High $2,344.23 | Facility | None | $44.67 | $107.15 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $77.62 Typical High $107.15 | Professional | None | $41.69 | $77.62 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | None | $69.18 | $69.18 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $3,235.94 Typical High $6,309.57 | Facility | None | $724.44 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $56.23 Typical High $75.86 | Professional | None | $35.48 | $56.23 | $75.86 |
CareSource Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $128.82 | Facility | None | $46.77 | $46.77 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $117.49 | Professional | None | $83.18 | $97.72 | $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 $48.98 Median $102.33 Typical High $173.78 | Professional | None | $48.98 | $102.33 | $173.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $107.15 Median $257.04 Typical High $954.99 | Facility | None | $107.15 | $257.04 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $46.77 Median $91.20 Typical High $162.18 | Professional | None | $46.77 | $91.20 | $162.18 |
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 $45.71 Median $93.33 Typical High $162.18 | Professional | None | $45.71 | $93.33 | $162.18 |
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 $20.89 Median $38.90 Typical High $43.65 | Professional | 52 · Reduced service | $20.89 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $15.49 Typical High $17.38 | Professional | 53 · Discontinued | $8.32 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $58.88 Typical High $66.07 | Professional | 54 · Surgery only | $30.90 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $11.75 Typical High $13.18 | Professional | 55 · Aftercare only | $6.17 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $7.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.17 | $7.76 | $8.71 |
Where Indiana sits
The same service costs 3.3 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· 49th of 51
$81.28
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.