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 $74.13 Median $77.62 Typical High $81.28 | Facility | None | $74.13 | $77.62 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $91.20 | Professional | None | $75.86 | $81.28 | $91.20 |
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 $21.88 Median $27.54 Typical High $42.66 | Professional | None | $21.88 | $27.54 | $42.66 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $46.77 Typical High $114.82 | Professional | None | $14.79 | $46.77 | $114.82 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $125.89 Median $912.01 Typical High $2,187.76 | Facility | None | $125.89 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $13.49 Median $25.70 Typical High $66.07 | Professional | None | $13.49 | $25.70 | $66.07 |
United Setting Professional Modifier None Typical Low $32.36 Median $72.44 Typical High $123.03 | Professional | None | $32.36 | $72.44 | $123.03 |
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 $38.90 Median $40.74 Typical High $45.71 | Professional | 52 · Reduced service | $38.90 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.22 Typical High $18.20 | Professional | 53 · Discontinued | $15.49 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $60.26 Typical High $69.18 | Professional | 54 · Surgery only | $57.54 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $13.80 | Professional | 55 · Aftercare only | $11.48 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.13 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.76 | $8.13 | $9.12 |
Where Indiana sits
The same service costs 4.5 times more in Alaska than in Ohio. 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· 45th of 51
$38.90
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.