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 $67.61 Median $93.33 Typical High $109.65 | Facility | None | $67.61 | $93.33 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $112.20 | Professional | None | $72.44 | $93.33 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $165.96 | Professional | None | $100.00 | $120.23 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $239.88 | Facility | None | $123.03 | $123.03 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $138.04 | Professional | None | $81.28 | $117.49 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $158.49 Typical High $245.47 | Facility | None | $74.13 | $158.49 | $245.47 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $154.88 | Professional | None | $107.15 | $120.23 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $147.91 | Professional | None | $69.18 | $100.00 | $147.91 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $213.80 Median $354.81 Typical High $2,187.76 | Facility | None | $213.80 | $354.81 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $165.96 | Professional | None | $70.79 | $107.15 | $165.96 |
United Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $134.90 | Professional | None | $72.44 | $102.33 | $134.90 |
5 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 $36.31 Median $45.71 Typical High $53.70 | Professional | 52 · Reduced service | $36.31 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.80 Typical High $16.22 | Professional | 55 · Aftercare only | $10.96 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.12 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.24 | $9.12 | $10.72 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $100.00 Median $131.83 Typical High $165.96 | Professional | 25 · Same-day visit | $100.00 | $131.83 | $165.96 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $117.49 Median $117.49 Typical High $151.36 | Professional | GC · Resident with teaching physician | $117.49 | $117.49 | $151.36 |
Where Indiana sits
The same service costs 2.8 times more in Alaska 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· 30th of 51
$107
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.