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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | None | $489.78 | $489.78 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $831.76 | Facility | None | $436.52 | $436.52 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $512.86 | Professional | None | $371.54 | $436.52 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $870.96 | Professional | None | $446.68 | $524.81 | $870.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $776.25 Median $1,412.54 Typical High $2,187.76 | Facility | None | $776.25 | $1,412.54 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $954.99 | Professional | None | $489.78 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $707.95 | Professional | None | $389.05 | $467.74 | $707.95 |
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 $245.47 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $97.72 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $81.28 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $53.70 |
Where Indiana sits
The same service costs 3.2 times more in Alaska than in New York. 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
$468
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.