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 $239.88 Median $2,691.53 Typical High $5,011.87 | Facility | None | $239.88 | $2,691.53 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $1,380.38 Typical High $3,467.37 | Professional | None | $218.78 | $1,380.38 | $3,467.37 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $11,481.54 Typical High $23,442.29 | Facility | None | $1,412.54 | $11,481.54 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $1,862.09 Typical High $3,235.94 | Professional | None | $194.98 | $1,862.09 | $3,235.94 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $8,709.64 | Facility | None | $245.47 | $245.47 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,606.93 Typical High $9,332.54 | Facility | None | $645.65 | $6,606.93 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $1,737.80 Typical High $4,365.16 | Professional | None | $263.03 | $1,737.80 | $4,365.16 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $645.65 Median $7,413.10 Typical High $10,964.78 | Facility | None | $645.65 | $7,413.10 | $10,964.78 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $204.17 Median $562.34 Typical High $4,073.80 | Professional | None | $204.17 | $562.34 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,230.27 | $4,677.35 | $12,022.64 |
United Setting Professional Modifier None Typical Low $239.88 Median $2,454.71 Typical High $5,754.40 | Professional | None | $239.88 | $2,454.71 | $5,754.40 |
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 $109.65 Median $1,047.13 Typical High $1,288.25 | Professional | 52 · Reduced service | $109.65 | $1,047.13 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $426.58 Typical High $512.86 | Professional | 53 · Discontinued | $43.65 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $1,584.89 Typical High $1,949.84 | Professional | 54 · Surgery only | $162.18 | $1,584.89 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $316.23 Typical High $389.05 | Professional | 55 · Aftercare only | $32.36 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $208.93 Typical High $257.04 | Professional | 56 · Pre-op care only | $21.88 | $208.93 | $257.04 |
Where Indiana sits
The same service costs 11.2 times more in Alaska than in Nebraska. 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· 35th of 51
$2,455
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.