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 $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $323.59 | Professional | None | $275.42 | $275.42 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $446.68 | Professional | None | $275.42 | $275.42 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $645.65 | Facility | None | $218.78 | $218.78 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $331.13 | Professional | None | $208.93 | $295.12 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $407.38 | Professional | None | $269.15 | $302.00 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $489.78 | Professional | None | $234.42 | $275.42 | $489.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $446.68 Median $891.25 Typical High $2,187.76 | Facility | None | $446.68 | $891.25 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $549.54 | Professional | None | $263.03 | $380.19 | $549.54 |
United Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $363.08 | Professional | None | $204.17 | $245.47 | $363.08 |
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 $138.04 Median $138.04 Typical High $151.36 | Professional | 52 · Reduced service | $138.04 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | 53 · Discontinued | $54.95 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $45.71 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $30.20 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $30.20 |
Where Indiana sits
The same service costs 2.8 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· 40th of 51
$282
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.