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 $165.96 Median $165.96 Typical High $331.13 | Facility | None | $165.96 | $165.96 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $213.80 | Professional | None | $162.18 | $165.96 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $1,023.29 Typical High $1,348.96 | Facility | None | $316.23 | $1,023.29 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $316.23 Typical High $338.84 | Professional | None | $158.49 | $316.23 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $169.82 Typical High $354.81 | Professional | None | $64.57 | $169.82 | $354.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $128.82 Median $478.63 Typical High $2,187.76 | Facility | None | $128.82 | $478.63 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $302.00 | Professional | None | $169.82 | $218.78 | $302.00 |
United Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $263.03 | Professional | None | $147.91 | $177.83 | $263.03 |
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 $81.28 Median $81.28 Typical High $107.15 | Professional | 52 · Reduced service | $81.28 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.11 Typical High $42.66 | Professional | 53 · Discontinued | $32.36 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $32.36 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.60 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.22 | $16.60 | $21.38 |
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· 34th of 51
$200
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.