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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $40.74 Typical High $40.74 | Professional | None | $26.30 | $40.74 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $37.15 | Facility | None | $19.50 | $19.50 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $47.86 | Professional | None | $19.50 | $19.50 | $47.86 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $70.79 | Facility | None | $69.18 | $69.18 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $239.88 | Professional | None | $19.50 | $19.50 | $239.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $42.66 Median $151.36 Typical High $2,137.96 | Facility | None | $42.66 | $151.36 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $70.79 | Professional | None | $30.20 | $38.90 | $70.79 |
United Setting Professional Modifier None Typical Low $13.49 Median $23.44 Typical High $38.90 | Professional | None | $13.49 | $23.44 | $38.90 |
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 $13.18 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $13.18 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $5.25 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $30.20 Typical High $30.20 | Professional | 54 · Surgery only | $19.95 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $3.98 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.63 | $4.07 | $4.07 |
Where Indiana sits
The same service costs 3.2 times more in Rhode Island 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· 45th of 51
$22.39
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.