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 $63.10 Median $1,380.38 Typical High $5,011.87 | Facility | None | $63.10 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $162.18 Typical High $204.17 | Professional | None | $63.10 | $162.18 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $123.03 | Facility | None | $63.10 | $63.10 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $104.71 Typical High $186.21 | Professional | None | $53.70 | $104.71 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $346.74 | Facility | None | $66.07 | $100.00 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $158.49 Typical High $281.84 | Professional | None | $67.61 | $158.49 | $281.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $91.20 Median $281.84 Typical High $2,089.30 | Facility | None | $91.20 | $281.84 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $74.13 Median $147.91 Typical High $302.00 | Professional | None | $74.13 | $147.91 | $302.00 |
United Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $275.42 | Professional | None | $66.07 | $154.88 | $275.42 |
5 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 $31.62 Median $83.18 Typical High $102.33 | Professional | 52 · Reduced service | $31.62 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $33.11 Typical High $40.74 | Professional | 53 · Discontinued | $12.59 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $123.03 Typical High $151.36 | Professional | 54 · Surgery only | $47.86 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $9.55 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $16.60 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.31 | $16.60 | $20.42 |
Where Indiana sits
The same service costs 2.9 times more in Washington than in Kentucky. 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
$120
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.