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 $70.79 Median $70.79 Typical High $141.25 | Facility | None | $70.79 | $70.79 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $93.33 | Professional | None | $70.79 | $70.79 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $144.54 Typical High $239.88 | Facility | None | $134.90 | $144.54 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $134.90 Typical High $147.91 | Professional | None | $69.18 | $134.90 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $74.13 Typical High $154.88 | Professional | None | $21.88 | $74.13 | $154.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $54.95 Median $208.93 Typical High $2,187.76 | Facility | None | $54.95 | $208.93 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $131.83 | Professional | None | $74.13 | $95.50 | $131.83 |
United Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $114.82 | Professional | None | $66.07 | $79.43 | $114.82 |
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 $34.67 Median $35.48 Typical High $46.77 | Professional | 52 · Reduced service | $34.67 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $18.62 | Professional | 53 · Discontinued | $14.13 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $14.13 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $9.33 |
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· 29th of 51
$89.13
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.