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 $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $16.98 Typical High $16.98 | Professional | None | $10.96 | $16.98 | $16.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $15.49 | Facility | None | $8.13 | $8.13 | $15.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $19.95 | Professional | None | $8.13 | $8.13 | $19.95 |
CareSource Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $29.51 | Facility | None | $28.84 | $28.84 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $97.72 | Professional | None | $8.13 | $8.13 | $97.72 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $17.78 Median $63.10 Typical High $2,137.96 | Facility | None | $17.78 | $63.10 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $12.88 Median $16.22 Typical High $29.51 | Professional | None | $12.88 | $16.22 | $29.51 |
United Setting Professional Modifier None Typical Low $5.62 Median $9.77 Typical High $16.22 | Professional | None | $5.62 | $9.77 | $16.22 |
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 $5.50 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $5.50 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $2.19 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.32 Median $12.59 Typical High $12.59 | Professional | 54 · Surgery only | $8.32 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $1.66 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.12 | $1.70 | $1.70 |
Where Indiana sits
The same service costs 2.8 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
$9.33
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.