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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $38.02 Typical High $38.02 | Professional | None | $24.55 | $38.02 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $34.67 | Facility | None | $18.20 | $18.20 | $34.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $44.67 | Professional | None | $18.20 | $18.20 | $44.67 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $66.07 | Facility | None | $63.10 | $63.10 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $25.12 | Facility | None | $15.49 | $15.49 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $213.80 | Professional | None | $18.20 | $18.20 | $213.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $39.81 Median $141.25 Typical High $2,137.96 | Facility | None | $39.81 | $141.25 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $28.18 Median $36.31 Typical High $66.07 | Professional | None | $28.18 | $36.31 | $66.07 |
United Setting Professional Modifier None Typical Low $12.30 Median $21.88 Typical High $36.31 | Professional | None | $12.30 | $21.88 | $36.31 |
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 $12.30 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $12.30 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $4.90 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $28.18 Typical High $28.18 | Professional | 54 · Surgery only | $18.62 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $3.72 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.45 | $3.80 | $3.80 |
Where Indiana sits
The same service costs 2.7 times more in Hawaii 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· 44th 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.