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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $79.43 Typical High $85.11 | Professional | None (both parts) | $79.43 | $79.43 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $1,148.15 Typical High $1,513.56 | Facility | None | $128.82 | $1,148.15 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $69.18 Median $128.82 Typical High $144.54 | Professional | None (both parts) | $69.18 | $128.82 | $144.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $83.18 Median $120.23 Typical High $426.58 | Professional | None (both parts) | $83.18 | $120.23 | $426.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $208.93 Median $912.01 Typical High $2,187.76 | Facility | None | $208.93 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None (both parts) Typical Low $85.11 Median $114.82 Typical High $147.91 | Professional | None (both parts) | $85.11 | $114.82 | $147.91 |
United Setting Professional Modifier None (both parts) Typical Low $81.28 Median $97.72 Typical High $162.18 | Professional | None (both parts) | $81.28 | $97.72 | $162.18 |
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 $39.81 Median $39.81 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.59 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $8.51 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $87.10 Median $93.33 Typical High $114.82 | Professional | TC · Technical part | $87.10 | $93.33 | $114.82 |
Where Indiana sits
The same service costs 2.9 times more in Alaska than in Florida. 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· 23rd of 51
$110
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.