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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $18.20 | Professional | None | $16.60 | $16.60 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $36.31 | Facility | None | $18.62 | $18.62 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $18.62 Typical High $20.89 | Professional | None | $15.85 | $18.62 | $20.89 |
CareSource Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
CareSource Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $24.55 Typical High $42.66 | Facility | None | $18.20 | $24.55 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $20.42 Typical High $33.11 | Professional | None | $17.78 | $20.42 | $33.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $26.30 Median $53.70 Typical High $2,187.76 | Facility | None | $26.30 | $53.70 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $16.60 Median $22.91 Typical High $34.67 | Professional | None | $16.60 | $22.91 | $34.67 |
United Setting Professional Modifier None Typical Low $15.14 Median $19.05 Typical High $28.84 | Professional | None | $15.14 | $19.05 | $28.84 |
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 $8.32 Median $8.32 Typical High $9.12 | Professional | 52 · Reduced service | $8.32 | $8.32 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $3.63 | Professional | 53 · Discontinued | $3.31 | $3.31 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $2.75 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.66 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.66 | $1.66 | $1.82 |
Where Indiana sits
The same service costs 3.4 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· 37th of 51
$18.62
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.