How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $33.11 Median $50.12 Typical High $63.10 | Facility | None | $33.11 | $50.12 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $48.98 Typical High $66.07 | Facility | None | $30.90 | $48.98 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $39.81 | Professional | None | $30.90 | $33.11 | $39.81 |
CareSource Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $53.70 | Facility | None | $30.20 | $30.20 | $53.70 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $33.11 | Professional | None | $30.20 | $30.20 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $89.13 Typical High $91.20 | Facility | None | $45.71 | $89.13 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $41.69 | Professional | None | $33.11 | $33.11 | $41.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $28.84 Median $60.26 Typical High $91.20 | Facility | None | $28.84 | $60.26 | $91.20 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $45.71 | Professional | None | $22.39 | $29.51 | $45.71 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $34.67 | Professional | None | $30.90 | $30.90 | $34.67 |
5 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 $16.60 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $4.90 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.31 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | JW · Drug discarded | $30.90 | $30.90 | $30.90 |
Where Indiana sits
Rates are fairly even across states for this service. 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· 12th of 51
$33.11
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.