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 $26.92 Median $30.20 Typical High $38.90 | Facility | None | $26.92 | $30.20 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $35.48 Typical High $67.61 | Professional | None | $26.92 | $35.48 | $67.61 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $58.88 | Professional | None | $35.48 | $46.77 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $87.10 | Facility | None | $40.74 | $40.74 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $54.95 | Professional | None | $36.31 | $45.71 | $54.95 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $50.12 | Facility | None | $43.65 | $43.65 | $50.12 |
CareSource Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $75.86 | Professional | None | $44.67 | $60.26 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $66.07 | Professional | None | $33.88 | $40.74 | $66.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $51.29 Median $131.83 Typical High $2,187.76 | Facility | None | $51.29 | $131.83 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $67.61 | Professional | None | $40.74 | $53.70 | $67.61 |
United Setting Professional Modifier None Typical Low $33.11 Median $39.81 Typical High $60.26 | Professional | None | $33.11 | $39.81 | $60.26 |
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 $17.78 Median $17.78 Typical High $21.88 | Professional | 52 · Reduced service | $17.78 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $6.46 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $4.37 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $41.69 Median $41.69 Typical High $53.70 | Professional | 57 · Decision for surgery | $41.69 | $41.69 | $53.70 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $54.95 Median $58.88 Typical High $58.88 | Professional | FS · Shared visit | $54.95 | $58.88 | $58.88 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | GC · Resident with teaching physician | $53.70 | $53.70 | $63.10 |
Where Indiana sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 47th of 51
$41.69
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.