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 $47.86 Median $79.43 Typical High $144.54 | Facility | None | $47.86 | $79.43 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $117.49 | Professional | None | $42.66 | $70.79 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $107.15 | Professional | None | $54.95 | $70.79 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,162.28 Typical High $6,309.57 | Facility | None | $741.31 | $3,162.28 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $44.67 Typical High $67.61 | Professional | None | $38.02 | $44.67 | $67.61 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $57.54 Median $67.61 Typical High $102.33 | Professional | 50 · Both sides | $57.54 | $67.61 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $48.98 Median $831.76 Typical High $1,230.27 | Facility | None | $48.98 | $831.76 | $1,230.27 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $102.33 | Professional | None | $72.44 | $83.18 | $102.33 |
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 $52.48 Median $83.18 Typical High $190.55 | Professional | None | $52.48 | $83.18 | $190.55 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $117.49 Median $229.09 Typical High $2,089.30 | Facility | None | $117.49 | $229.09 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $47.86 Median $83.18 Typical High $134.90 | Professional | None | $47.86 | $83.18 | $134.90 |
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 $46.77 Median $83.18 Typical High $144.54 | Professional | None | $46.77 | $83.18 | $144.54 |
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 $33.11 Typical High $36.31 | Professional | 52 · Reduced service | $20.89 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $13.49 Typical High $14.45 | Professional | 53 · Discontinued | $8.51 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $50.12 Typical High $54.95 | Professional | 54 · Surgery only | $31.62 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $10.00 Typical High $10.96 | Professional | 55 · Aftercare only | $6.31 | $10.00 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.61 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.27 | $6.61 | $7.24 |
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· 50th of 51
$70.79
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.