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 $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $28.18 Typical High $28.18 | Professional | None | $18.20 | $28.18 | $28.18 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | None | $34.67 | $34.67 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $26.30 | Facility | None | $13.80 | $13.80 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $33.88 | Professional | None | $13.80 | $13.80 | $33.88 |
CareSource Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $50.12 | Facility | None | $47.86 | $47.86 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $162.18 | Professional | None | $13.80 | $13.80 | $162.18 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $30.20 Median $107.15 Typical High $2,137.96 | Facility | None | $30.20 | $107.15 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $21.38 Median $27.54 Typical High $48.98 | Professional | None | $21.38 | $27.54 | $48.98 |
United Setting Professional Modifier None Typical Low $9.33 Median $16.60 Typical High $27.54 | Professional | None | $9.33 | $16.60 | $27.54 |
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 $9.33 Median $14.13 Typical High $14.13 | Professional | 52 · Reduced service | $9.33 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $5.62 Typical High $5.62 | Professional | 53 · Discontinued | $3.72 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $21.38 Typical High $21.38 | Professional | 54 · Surgery only | $14.13 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $2.82 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.86 | $2.82 | $2.82 |
Where Indiana sits
The same service costs 2.6 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· 48th of 51
$15.85
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.