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 $67.61 Median $3,801.89 Typical High $5,623.41 | Facility | None | $67.61 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $134.90 Typical High $177.83 | Professional | None | $67.61 | $134.90 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $138.04 Typical High $295.12 | Professional | None | $67.61 | $138.04 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $91.20 Typical High $346.74 | Facility | None | $75.86 | $91.20 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $281.84 | Professional | None | $67.61 | $154.88 | $281.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $134.90 Median $407.38 Typical High $2,187.76 | Facility | None | $134.90 | $407.38 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $61.66 Median $128.82 Typical High $245.47 | Professional | None | $61.66 | $128.82 | $245.47 |
United Setting Professional Modifier None Typical Low $63.10 Median $134.90 Typical High $281.84 | Professional | None | $63.10 | $134.90 | $281.84 |
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 $33.88 Median $67.61 Typical High $85.11 | Professional | 52 · Reduced service | $33.88 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $26.92 Typical High $34.67 | Professional | 53 · Discontinued | $13.49 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $102.33 Typical High $128.82 | Professional | 54 · Surgery only | $51.29 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $20.42 Typical High $25.70 | Professional | 55 · Aftercare only | $10.23 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $13.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $6.76 | $13.49 | $17.38 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 24th of 51
$158
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.