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 $31.62 Median $95.50 Typical High $3,801.89 | Facility | None | $31.62 | $95.50 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $58.88 Typical High $117.49 | Professional | None | $33.88 | $58.88 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $20.42 Median $23.99 Typical High $44.67 | Professional | None | $20.42 | $23.99 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,090.30 Typical High $6,165.95 | Facility | None | $616.60 | $3,090.30 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $54.95 Typical High $95.50 | Professional | None | $29.51 | $54.95 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $36.31 | Facility | None | $32.36 | $32.36 | $36.31 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $123.03 | Professional | None | $91.20 | $100.00 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $48.98 Typical High $144.54 | Professional | None | $28.18 | $48.98 | $144.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $60.26 Median $190.55 Typical High $954.99 | Facility | None | $60.26 | $190.55 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $28.18 Median $70.79 Typical High $144.54 | Professional | None | $28.18 | $70.79 | $144.54 |
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 $26.30 Median $61.66 Typical High $141.25 | Professional | None | $26.30 | $61.66 | $141.25 |
3 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 54 · Surgery only Typical Low $25.12 Median $32.36 Typical High $77.62 | Professional | 54 · Surgery only | $25.12 | $32.36 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $6.46 Typical High $15.85 | Professional | 55 · Aftercare only | $5.01 | $6.46 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.37 Typical High $10.47 | Professional | 56 · Pre-op care only | $3.39 | $4.37 | $10.47 |
Where Indiana sits
The same service costs 2.8 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· 28th of 51
$75.86
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.