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 $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $512.86 | Professional | None | $467.74 | $467.74 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $794.33 | Facility | None | $416.87 | $416.87 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $501.19 | Professional | None | $354.81 | $416.87 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
CareSource Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $537.03 Typical High $891.25 | Facility | None | $407.38 | $537.03 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $831.76 | Professional | None | $426.58 | $489.78 | $831.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $741.31 Median $1,348.96 Typical High $2,187.76 | Facility | None | $741.31 | $1,348.96 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $933.25 | Professional | None | $478.63 | $645.65 | $933.25 |
United Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $691.83 | Professional | None | $371.54 | $446.68 | $691.83 |
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 $234.42 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $234.42 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $51.29 |
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
$447
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.