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 $29.51 Median $39.81 Typical High $83.18 | Facility | None | $29.51 | $39.81 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $70.79 Typical High $91.20 | Professional | None | $29.51 | $70.79 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $218.78 Typical High $295.12 | Facility | None | $53.70 | $218.78 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $72.44 Typical High $147.91 | Professional | None | $30.90 | $72.44 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
CareSource Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $57.54 Typical High $138.04 | Professional | None | $26.92 | $57.54 | $138.04 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $20.42 Median $70.79 Typical High $2,089.30 | Facility | None | $20.42 | $70.79 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $32.36 Median $79.43 Typical High $144.54 | Professional | None | $32.36 | $79.43 | $144.54 |
United Setting Professional Modifier None Typical Low $27.54 Median $63.10 Typical High $123.03 | Professional | None | $27.54 | $63.10 | $123.03 |
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 $14.45 Median $35.48 Typical High $44.67 | Professional | 52 · Reduced service | $14.45 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $14.13 Typical High $17.78 | Professional | 53 · Discontinued | $5.89 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $10.72 Typical High $13.18 | Professional | 55 · Aftercare only | $4.37 | $10.72 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $7.41 Typical High $8.91 | Professional | 56 · Pre-op care only | $2.95 | $7.41 | $8.91 |
Where Indiana sits
The same service costs 3.6 times more in North Carolina 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· 41st of 51
$67.61
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.