How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $63.10 Median $67.61 Typical High $83.18 | Facility | None | $63.10 | $67.61 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $83.18 | Professional | None | $67.61 | $67.61 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $75.86 | Professional | None | $46.77 | $54.95 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $2,089.30 Typical High $2,818.38 | Facility | None | $79.43 | $2,089.30 | $2,818.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $97.72 | Professional | None | $58.88 | $79.43 | $97.72 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $97.72 | Professional | None | $64.57 | $72.44 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $144.54 | Professional | None | $67.61 | $74.13 | $144.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $177.83 Median $912.01 Typical High $2,187.76 | Facility | None | $177.83 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $131.83 | Professional | None | $67.61 | $81.28 | $131.83 |
United Setting Professional Modifier None Typical Low $60.26 Median $74.13 Typical High $107.15 | Professional | None | $60.26 | $74.13 | $107.15 |
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 $33.88 Median $33.88 Typical High $37.15 | Professional | 52 · Reduced service | $33.88 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $14.79 | Professional | 53 · Discontinued | $13.49 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $11.22 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.41 |
Where Indiana sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 42nd of 51
$72.44
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.