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 $10.00 Median $15.14 Typical High $61.66 | Facility | None | $10.00 | $15.14 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $51.29 | Professional | None | $10.00 | $10.00 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.89 Median $144.54 Typical High $190.55 | Facility | None | $20.89 | $144.54 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $20.89 Typical High $43.65 | Professional | None | $17.78 | $20.89 | $43.65 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $34.67 | Professional | None | $30.20 | $30.20 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $26.30 Typical High $27.54 | Professional | None | $14.45 | $26.30 | $27.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,290.87 | Facility | None | $912.01 | $2,089.30 | $2,290.87 |
United Setting Professional Modifier None Typical Low $13.49 Median $19.50 Typical High $30.90 | Professional | None | $13.49 | $19.50 | $30.90 |
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 $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where Indiana sits
The same service costs 6.6 times more in Alabama than in Kansas. 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· 41st of 51
$20.89
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.