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 $47.86 Median $47.86 Typical High $83.18 | Facility | None | $47.86 | $47.86 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $87.10 | Professional | None | $47.86 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $36.31 Typical High $43.65 | Professional | 52 · Reduced service | $23.99 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $14.45 Typical High $17.38 | Professional | 53 · Discontinued | $9.55 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.96 Typical High $13.18 | Professional | 55 · Aftercare only | $7.24 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.24 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.79 | $7.24 | $8.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $97.72 | Facility | None | $50.12 | $50.12 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $83.18 | Professional | None | $50.12 | $70.79 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $97.72 | Professional | None | $89.13 | $91.20 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $102.33 | Professional | None | $46.77 | $72.44 | $102.33 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $141.25 Median $288.40 Typical High $2,187.76 | Facility | None | $141.25 | $288.40 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $134.90 | Professional | None | $57.54 | $93.33 | $134.90 |
United Setting Professional Modifier None Typical Low $30.20 Median $61.66 Typical High $102.33 | Professional | None | $30.20 | $61.66 | $102.33 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Indiana sits
The same service costs 3.0 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· 41st of 51
$70.79
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.