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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | None | $83.18 | $83.18 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $229.09 | Facility | None | $120.23 | $120.23 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $141.25 | Professional | None | $74.13 | $120.23 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $190.55 | Professional | None | $89.13 | $112.20 | $190.55 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $181.97 Median $239.88 Typical High $2,187.76 | Facility | None | $181.97 | $239.88 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $162.18 | Professional | None | $85.11 | $102.33 | $162.18 |
United Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $138.04 | Professional | None | $75.86 | $93.33 | $138.04 |
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 $41.69 Median $41.69 Typical High $45.71 | Professional | 52 · Reduced service | $41.69 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $18.20 | Professional | 53 · Discontinued | $16.60 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $13.80 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $9.12 |
Where Indiana sits
The same service costs 3.1 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· 25th of 51
$102
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.