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 $44.67 Median $50.12 Typical High $66.07 | Facility | None | $44.67 | $50.12 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $58.88 Typical High $114.82 | Professional | None | $44.67 | $58.88 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $97.72 | Professional | None | $70.79 | $79.43 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $190.55 | Facility | None | $97.72 | $97.72 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $128.82 | Professional | None | $70.79 | $97.72 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $85.11 | Facility | None | $72.44 | $72.44 | $85.11 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $125.89 | Professional | None | $75.86 | $102.33 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $134.90 | Professional | None | $69.18 | $95.50 | $134.90 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $102.33 Median $223.87 Typical High $2,187.76 | Facility | None | $102.33 | $223.87 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $114.82 | Professional | None | $67.61 | $91.20 | $114.82 |
United Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $141.25 | Professional | None | $79.43 | $97.72 | $141.25 |
6 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 $29.51 Median $29.51 Typical High $41.69 | Professional | 52 · Reduced service | $29.51 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $12.59 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $8.32 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $70.79 Median $70.79 Typical High $93.33 | Professional | 25 · Same-day visit | $70.79 | $70.79 | $93.33 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | 57 · Decision for surgery | $89.13 | $93.33 | $93.33 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $91.20 Median $93.33 Typical High $104.71 | Professional | FS · Shared visit | $91.20 | $93.33 | $104.71 |
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· 48th of 51
$83.18
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.