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 $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $10.72 Typical High $21.88 | Professional | None | $9.55 | $10.72 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $4,073.80 Typical High $7,413.10 | Facility | None | $2,290.87 | $4,073.80 | $7,413.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $346.74 | Professional | None | $213.80 | $302.00 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $23.99 Median $363.08 Typical High $537.03 | Facility | None | $23.99 | $363.08 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $398.11 | Professional | None | $199.53 | $199.53 | $398.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $33.11 | Professional | None | $20.89 | $20.89 | $33.11 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $4,570.88 | Facility | None | $933.25 | $2,290.87 | $4,570.88 |
United Setting Professional Modifier None Typical Low $14.79 Median $20.89 Typical High $35.48 | Professional | None | $14.79 | $20.89 | $35.48 |
4 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 $4.79 Median $5.37 Typical High $10.72 | Professional | 52 · Reduced service | $4.79 | $5.37 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $2.14 Typical High $4.37 | Professional | 53 · Discontinued | $1.91 | $2.14 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.62 Typical High $3.24 | Professional | 55 · Aftercare only | $1.45 | $1.62 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.07 Typical High $2.19 | Professional | 56 · Pre-op care only | $0.95 | $1.07 | $2.19 |
Where Indiana sits
The same service costs 19.1 times more in Indiana than in Delaware. 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· 1st of 51
$257
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.