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 $93.33 Median $158.49 Typical High $426.58 | Facility | None | $93.33 | $158.49 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $371.54 | Professional | None | $67.61 | $93.33 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $97.72 | Professional | None | $48.98 | $57.54 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $114.82 Typical High $346.74 | Facility | None | $91.20 | $114.82 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $45.71 Typical High $125.89 | Professional | None | $31.62 | $45.71 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $144.54 | Facility | None | $102.33 | $102.33 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $131.83 | Professional | None | $74.13 | $114.82 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $114.82 Typical High $323.59 | Facility | None | $74.13 | $114.82 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $141.25 | Professional | None | $42.66 | $60.26 | $141.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $131.83 Median $288.40 Typical High $2,187.76 | Facility | None | $131.83 | $288.40 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $100.00 | Professional | None | $72.44 | $93.33 | $100.00 |
United Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $138.04 | Professional | None | $44.67 | $67.61 | $138.04 |
5 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 $42.66 Median $46.77 Typical High $100.00 | Professional | 52 · Reduced service | $42.66 | $46.77 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $39.81 | Professional | 53 · Discontinued | $16.98 | $18.62 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $70.79 Typical High $151.36 | Professional | 54 · Surgery only | $64.57 | $70.79 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.13 Typical High $30.20 | Professional | 55 · Aftercare only | $12.88 | $14.13 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $19.95 |
Where Indiana sits
The same service costs 4.9 times more in Alaska than in Georgia. 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
$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.