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 $17.78 Median $17.78 Typical High $67.61 | Facility | None | $17.78 | $17.78 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $54.95 Typical High $70.79 | Professional | None | $17.78 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $27.54 Typical High $35.48 | Professional | 52 · Reduced service | $8.91 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $11.22 Typical High $14.45 | Professional | 53 · Discontinued | $3.55 | $11.22 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $8.32 Typical High $10.72 | Professional | 55 · Aftercare only | $2.69 | $8.32 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $5.62 Typical High $7.08 | Professional | 56 · Pre-op care only | $1.78 | $5.62 | $7.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.05 Median $407.38 Typical High $549.54 | Facility | None | $19.05 | $407.38 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $36.31 Typical High $43.65 | Professional | None | $19.05 | $36.31 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $45.71 Typical High $74.13 | Professional | None | $16.98 | $45.71 | $74.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $52.48 Median $223.87 Typical High $2,187.76 | Facility | None | $52.48 | $223.87 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $21.38 Median $39.81 Typical High $107.15 | Professional | None | $21.38 | $39.81 | $107.15 |
United Setting Professional Modifier None Typical Low $18.20 Median $33.11 Typical High $75.86 | Professional | None | $18.20 | $33.11 | $75.86 |
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 4.4 times more in Hawaii 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· 49th of 51
$33.11
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.