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 $39.81 Median $39.81 Typical High $79.43 | Facility | None | $39.81 | $39.81 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $41.69 | Professional | None | $39.81 | $39.81 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.57 Median $25.70 Typical High $50.12 | Facility | None | $4.57 | $25.70 | $50.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $39.81 | Professional | None | $25.70 | $25.70 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $64.57 Typical High $70.79 | Facility | None | $28.18 | $64.57 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $70.79 | Professional | None | $25.70 | $25.70 | $70.79 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $16.98 Median $20.89 Typical High $29.51 | Professional | None | $16.98 | $20.89 | $29.51 |
United Setting Professional Modifier None Typical Low $28.84 Median $70.79 Typical High $120.23 | Professional | None | $28.84 | $70.79 | $120.23 |
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 $19.50 Median $19.50 Typical High $20.89 | Professional | 52 · Reduced service | $19.50 | $19.50 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $8.32 | Professional | 53 · Discontinued | $7.94 | $7.94 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $6.31 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.17 |
Where Indiana sits
The same service costs 3.1 times more in Wisconsin than in New York. 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· 40th of 51
$30.90
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.