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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $20.89 | Professional | None | $16.60 | $16.60 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $57.54 | Facility | None | $30.20 | $30.20 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $46.77 | Professional | None | $25.70 | $30.20 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $30.90 Typical High $46.77 | Facility | None | $18.62 | $30.90 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $31.62 Typical High $57.54 | Professional | None | $20.42 | $31.62 | $57.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,290.87 | Facility | None | $912.01 | $2,089.30 | $2,290.87 |
United Setting Professional Modifier None Typical Low $17.38 Median $22.39 Typical High $33.11 | Professional | None | $17.38 | $22.39 | $33.11 |
4 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 $8.32 Median $8.32 Typical High $10.00 | Professional | 52 · Reduced service | $8.32 | $8.32 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $4.07 | Professional | 53 · Discontinued | $3.31 | $3.31 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $3.02 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.66 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.66 | $1.66 | $2.04 |
Where Indiana sits
The same service costs 4.3 times more in Alaska than in New York. 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· 12th of 51
$30.20
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.