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 $100.00 Median $100.00 Typical High $199.53 | Facility | None | $100.00 | $100.00 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $100.00 Typical High $131.83 | Professional | None | $97.72 | $100.00 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $181.97 Median $1,023.29 Typical High $1,348.96 | Facility | None | $181.97 | $1,023.29 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $181.97 Typical High $194.98 | Professional | None | $97.72 | $181.97 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $100.00 Typical High $204.17 | Professional | None | $57.54 | $100.00 | $204.17 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $77.62 Median $295.12 Typical High $2,187.76 | Facility | None | $77.62 | $295.12 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $186.21 | Professional | None | $104.71 | $134.90 | $186.21 |
United Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $154.88 | Professional | None | $87.10 | $107.15 | $154.88 |
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 $48.98 Median $50.12 Typical High $66.07 | Professional | 52 · Reduced service | $48.98 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.95 Typical High $26.30 | Professional | 53 · Discontinued | $19.50 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.14 Typical High $19.50 | Professional | 55 · Aftercare only | $14.79 | $15.14 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.00 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.77 | $10.00 | $13.18 |
Where Indiana sits
The same service costs 3.0 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· 32nd 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.