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 $38.02 Median $41.69 Typical High $53.70 | Facility | None | $38.02 | $41.69 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $57.54 | Professional | None | $41.69 | $50.12 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $64.57 | Professional | None | $52.48 | $61.66 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $128.82 | Facility | None | $66.07 | $66.07 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $81.28 | Professional | None | $48.98 | $66.07 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $48.98 | Facility | None | $42.66 | $42.66 | $48.98 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $63.10 Typical High $81.28 | Professional | None | $57.54 | $63.10 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $85.11 | Professional | None | $50.12 | $61.66 | $85.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $123.03 Median $186.21 Typical High $2,187.76 | Facility | None | $123.03 | $186.21 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $89.13 | Professional | None | $39.81 | $56.23 | $89.13 |
United Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $81.28 | Professional | None | $45.71 | $58.88 | $81.28 |
3 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 $20.89 Median $24.55 Typical High $28.84 | Professional | 52 · Reduced service | $20.89 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.24 Typical High $8.71 | Professional | 55 · Aftercare only | $6.31 | $7.24 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.90 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.17 | $4.90 | $5.75 |
Where Indiana sits
The same service costs 2.7 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· 23rd of 51
$61.66
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.