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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | None | $77.62 | $77.62 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $173.78 | Facility | None | $89.13 | $89.13 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $114.82 | Professional | None | $75.86 | $89.13 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $158.49 | Professional | None | $83.18 | $102.33 | $158.49 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $223.87 Median $912.01 Typical High $2,187.76 | Facility | None | $223.87 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $147.91 | Professional | None | $75.86 | $95.50 | $147.91 |
United Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $151.36 | Professional | None | $75.86 | $95.50 | $151.36 |
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 $38.90 Median $38.90 Typical High $43.65 | Professional | 52 · Reduced service | $38.90 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $17.78 | Professional | 53 · Discontinued | $15.49 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $13.18 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $8.91 |
Where Indiana sits
The same service costs 2.9 times more in Alaska than in Utah. 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· 40th 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.