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 $42.66 Median $48.98 Typical High $61.66 | Facility | None | $42.66 | $48.98 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $87.10 | Professional | None | $42.66 | $57.54 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $95.50 | Professional | None | $57.54 | $75.86 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $141.25 | Facility | None | $72.44 | $72.44 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $97.72 | Professional | None | $61.66 | $72.44 | $97.72 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $81.28 | Facility | None | $70.79 | $70.79 | $81.28 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $120.23 | Professional | None | $72.44 | $97.72 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $120.23 | Professional | None | $56.23 | $74.13 | $120.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $74.13 Median $213.80 Typical High $2,187.76 | Facility | None | $74.13 | $213.80 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $109.65 | Professional | None | $64.57 | $85.11 | $109.65 |
United Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $107.15 | Professional | None | $58.88 | $70.79 | $107.15 |
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 $28.84 Median $28.84 Typical High $35.48 | Professional | 52 · Reduced service | $28.84 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $10.72 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $7.24 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $89.13 Median $95.50 Typical High $95.50 | Professional | 24 · Unrelated visit after surgery | $89.13 | $95.50 | $95.50 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $57.54 Median $67.61 Typical High $85.11 | Professional | 25 · Same-day visit | $57.54 | $67.61 | $85.11 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $67.61 Median $89.13 Typical High $102.33 | Professional | GC · Resident with teaching physician | $67.61 | $89.13 | $102.33 |
Where Indiana sits
The same service costs 2.4 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· 46th of 51
$69.18
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.