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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $169.82 | Professional | None | $114.82 | $117.49 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $151.36 | Professional | None | $104.71 | $151.36 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $257.04 | Facility | None | $134.90 | $134.90 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $158.49 | Professional | None | $102.33 | $134.90 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $245.47 | Professional | None | $114.82 | $128.82 | $245.47 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $257.04 Median $331.13 Typical High $2,187.76 | Facility | None | $257.04 | $331.13 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $218.78 | Professional | None | $117.49 | $144.54 | $218.78 |
United Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $181.97 | Professional | None | $104.71 | $123.03 | $181.97 |
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 $57.54 Median $57.54 Typical High $63.10 | Professional | 52 · Reduced service | $57.54 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $25.70 | Professional | 53 · Discontinued | $22.91 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $19.05 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $12.59 |
Where Indiana sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 40th of 51
$126
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.