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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | None | $229.09 | $229.09 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $63.10 | Facility | None | $32.36 | $32.36 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $32.36 Typical High $269.15 | Professional | None | $27.54 | $32.36 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $204.17 | Facility | None | $186.21 | $186.21 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $204.17 | Professional | None | $42.66 | $42.66 | $204.17 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $524.81 Median $912.01 Typical High $2,187.76 | Facility | None | $524.81 | $912.01 | $2,187.76 |
United Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $467.74 | Professional | None | $186.21 | $257.04 | $467.74 |
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 $114.82 Median $114.82 Typical High $128.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $52.48 | Professional | 53 · Discontinued | $46.77 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $26.30 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $26.30 |
Where Indiana sits
The same service costs 26.9 times more in Alaska than in Virginia. 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· 50th of 51
$50.12
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.