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 $37.15 Median $37.15 Typical High $83.18 | Facility | None | $37.15 | $37.15 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $67.61 Typical High $85.11 | Professional | None | $37.15 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $33.88 Typical High $42.66 | Professional | 52 · Reduced service | $18.62 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $13.49 Typical High $17.38 | Professional | 53 · Discontinued | $7.41 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $10.23 Typical High $12.88 | Professional | 55 · Aftercare only | $5.50 | $10.23 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.46 Typical High $8.51 | Professional | 56 · Pre-op care only | $3.72 | $6.46 | $8.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $37.15 Median $407.38 Typical High $549.54 | Facility | None | $37.15 | $407.38 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $64.57 | Professional | None | $37.15 | $53.70 | $64.57 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $69.18 Typical High $93.33 | Professional | None | $37.15 | $69.18 | $93.33 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $107.15 Median $275.42 Typical High $2,187.76 | Facility | None | $107.15 | $275.42 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $131.83 | Professional | None | $41.69 | $79.43 | $131.83 |
United Setting Professional Modifier None Typical Low $30.20 Median $50.12 Typical High $97.72 | Professional | None | $30.20 | $50.12 | $97.72 |
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 2.5 times more in Alaska than in Washington, DC. 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· 47th of 51
$56.23
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.