How much rates vary
Facilitymedian $2,138 · 10th to 90th $68 to $5,370Professionalmedian $17 · 10th to 90th $12 to $26
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 $16.22 Median $21.88 Typical High $5,495.41 | Facility | None | $16.22 | $21.88 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $13.49 Typical High $24.55 | Professional | None | $12.59 | $13.49 | $24.55 |
Ambetter Setting Professional Modifier None Typical Low $12.30 Median $16.60 Typical High $21.88 | Professional | None | $12.30 | $16.60 | $21.88 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $18.62 Median $25.12 Typical High $30.90 | Professional | 50 · Both sides | $18.62 | $25.12 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $3,162.28 Typical High $6,309.57 | Facility | None | $549.54 | $3,162.28 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $17.38 Typical High $28.18 | Professional | None | $10.96 | $17.38 | $28.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $16.60 Median $26.30 Typical High $41.69 | Professional | 50 · Both sides | $16.60 | $26.30 | $41.69 |
CareSource Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
CareSource Setting Professional Modifier None Typical Low $13.49 Median $15.85 Typical High $18.62 | Professional | None | $13.49 | $15.85 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $575.44 Typical High $933.25 | Facility | None | $66.07 | $575.44 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $17.38 Typical High $30.20 | Professional | None | $14.13 | $17.38 | $30.20 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $46.77 Median $912.01 Typical High $2,137.96 | Facility | None | $46.77 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $15.85 Median $19.50 Typical High $30.20 | Professional | None | $15.85 | $19.50 | $30.20 |
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 $11.75 Median $15.49 Typical High $26.30 | Professional | None | $11.75 | $15.49 | $26.30 |
6 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 $6.17 Median $6.76 Typical High $7.76 | Professional | 52 · Reduced service | $6.17 | $6.76 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.75 Typical High $3.09 | Professional | 53 · Discontinued | $2.45 | $2.75 | $3.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.55 Median $10.23 Typical High $10.96 | Professional | 54 · Surgery only | $9.55 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $2.04 Typical High $2.34 | Professional | 55 · Aftercare only | $1.86 | $2.04 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.35 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.23 | $1.35 | $1.55 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $12.30 Median $14.45 Typical High $18.62 | Professional | 59 · Distinct service | $12.30 | $14.45 | $18.62 |
Where Indiana sits
The same service costs 7.4 times more in Kansas 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· 37th of 51
$19.05
KS $95.50KY $12.88
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.