How much rates vary
Facilitymedian $105 · 10th to 90th $74 to $219Professionalmedian $141 · 10th to 90th $89 to $182
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 $102.33 Typical High $162.18 | Facility | None | $74.13 | $102.33 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $144.54 | Professional | None | $75.86 | $102.33 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $213.80 | Professional | None | $95.50 | $154.88 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $323.59 | Facility | None | $162.18 | $162.18 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $173.78 | Professional | None | $112.20 | $158.49 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $138.04 | Facility | None | $120.23 | $120.23 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $223.87 | Professional | None | $154.88 | $169.82 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $162.18 | Facility | None | $102.33 | $102.33 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $218.78 | Professional | None | $114.82 | $141.25 | $218.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $251.19 Median $416.87 Typical High $2,089.30 | Facility | None | $251.19 | $416.87 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $234.42 | Professional | None | $112.20 | $158.49 | $234.42 |
United Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $190.55 | Professional | None | $112.20 | $144.54 | $190.55 |
11 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 Facility Modifier 52 · Reduced service Typical Low $47.86 Median $57.54 Typical High $64.57 | Facility | 52 · Reduced service | $47.86 | $57.54 | $64.57 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $16.98 Typical High $19.50 | Facility | 55 · Aftercare only | $14.45 | $16.98 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.48 Typical High $12.88 | Facility | 56 · Pre-op care only | $9.55 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $60.26 Typical High $70.79 | Professional | 52 · Reduced service | $47.86 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.78 Typical High $21.38 | Professional | 55 · Aftercare only | $14.45 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.02 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.55 | $12.02 | $14.13 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $112.20 Median $165.96 Typical High $223.87 | Professional | 25 · Same-day visit | $112.20 | $165.96 | $223.87 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $112.20 Median $165.96 Typical High $181.97 | Professional | 57 · Decision for surgery | $112.20 | $165.96 | $181.97 |
Ambetter Setting Professional Modifier AI · Physician of record Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | AI · Physician of record | $125.89 | $125.89 | $125.89 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $141.25 Median $165.96 Typical High $223.87 | Professional | GC · Resident with teaching physician | $141.25 | $165.96 | $223.87 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | Q6 · Substitute physician, paid per time | $181.97 | $181.97 | $181.97 |
Where Indiana sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 36th of 51
$141
AK $263AL $115
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.