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 $208.93 Median $281.84 Typical High $371.54 | Facility | None | $208.93 | $281.84 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $380.19 | Professional | None | $213.80 | $288.40 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $512.86 | Professional | None | $295.12 | $398.11 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $549.54 Typical High $724.44 | Facility | None | $281.84 | $549.54 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $398.11 | Professional | None | $239.88 | $316.23 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $549.54 | Professional | None | $407.38 | $457.09 | $549.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $562.34 | Professional | None | $323.59 | $380.19 | $562.34 |
United Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $562.34 | Professional | None | $269.15 | $380.19 | $562.34 |
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 $138.04 Median $186.21 Typical High $213.80 | Professional | 52 · Reduced service | $138.04 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $74.13 Typical High $87.10 | Professional | 53 · Discontinued | $56.23 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $56.23 Typical High $64.57 | Professional | 55 · Aftercare only | $41.69 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $37.15 Typical High $43.65 | Professional | 56 · Pre-op care only | $27.54 | $37.15 | $43.65 |
Where Indiana sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 48th of 51
$316
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.