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 $112.20 Median $3,467.37 Typical High $16,595.87 | Facility | None | $112.20 | $3,467.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $288.40 | Professional | None | $112.20 | $186.21 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $269.15 | Professional | None | $162.18 | $162.18 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $9,549.93 | Facility | None | $1,380.38 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $199.53 Typical High $467.74 | Professional | None | $100.00 | $199.53 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $302.00 Typical High $707.95 | Professional | 50 · Both sides | $151.36 | $302.00 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $295.12 | Facility | None | $125.89 | $125.89 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $295.12 Typical High $2,344.23 | Facility | None | $177.83 | $295.12 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $309.03 Typical High $1,258.93 | Professional | None | $134.90 | $309.03 | $1,258.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $281.84 Median $467.74 Typical High $2,290.87 | Facility | None | $281.84 | $467.74 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $380.19 | Professional | None | $125.89 | $229.09 | $380.19 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $123.03 Median $239.88 Typical High $794.33 | Professional | None | $123.03 | $239.88 | $794.33 |
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 $54.95 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $54.95 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $22.39 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $138.04 Typical High $154.88 | Professional | 54 · Surgery only | $83.18 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $27.54 Typical High $30.90 | Professional | 55 · Aftercare only | $16.60 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.22 | $18.20 | $20.89 |
Where Indiana sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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
$257
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.