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 $61.66 Median $1,380.38 Typical High $5,011.87 | Facility | None | $61.66 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $128.82 Typical High $151.36 | Professional | None | $61.66 | $128.82 | $151.36 |
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 $52.48 Median $97.72 Typical High $144.54 | Professional | None | $52.48 | $97.72 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $288.40 | Facility | None | $66.07 | $100.00 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $234.42 | Professional | None | $67.61 | $131.83 | $234.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $89.13 Median $213.80 Typical High $2,089.30 | Facility | None | $89.13 | $213.80 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $67.61 Median $144.54 Typical High $234.42 | Professional | None | $67.61 | $144.54 | $234.42 |
United Setting Professional Modifier None Typical Low $64.57 Median $128.82 Typical High $229.09 | Professional | None | $64.57 | $128.82 | $229.09 |
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 $30.90 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $30.90 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $22.91 Typical High $30.20 | Professional | 53 · Discontinued | $12.59 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $85.11 Typical High $114.82 | Professional | 54 · Surgery only | $46.77 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $9.33 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.31 | $11.48 | $15.14 |
Where Indiana sits
The same service costs 3.5 times more in Alaska 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· 48th of 51
$107
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.