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 $43.65 Median $48.98 Typical High $63.10 | Facility | None | $43.65 | $48.98 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $87.10 | Professional | None | $43.65 | $58.88 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $100.00 | Professional | None | $60.26 | $81.28 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $147.91 | Facility | None | $75.86 | $75.86 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $109.65 | Professional | None | $64.57 | $75.86 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $83.18 | Facility | None | $72.44 | $72.44 | $83.18 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $123.03 | Professional | None | $74.13 | $100.00 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $117.49 | Professional | None | $67.61 | $75.86 | $117.49 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $74.13 Median $218.78 Typical High $2,187.76 | Facility | None | $74.13 | $218.78 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $117.49 | Professional | None | $66.07 | $89.13 | $117.49 |
United Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $107.15 | Professional | None | $61.66 | $74.13 | $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 $36.31 | Professional | 52 · Reduced service | $28.84 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $10.72 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $7.24 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | 24 · Unrelated visit after surgery | $70.79 | $70.79 | $91.20 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $85.11 Median $89.13 Typical High $95.50 | Professional | 25 · Same-day visit | $85.11 | $89.13 | $95.50 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $72.44 Median $93.33 Typical High $107.15 | Professional | GC · Resident with teaching physician | $72.44 | $93.33 | $107.15 |
Where Indiana sits
The same service costs 2.3 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· 44th of 51
$74.13
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.