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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $125.89 | Professional | None | $83.18 | $125.89 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $117.49 | Facility | None | $60.26 | $60.26 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $151.36 | Professional | None | $60.26 | $60.26 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $218.78 | Facility | None | $213.80 | $213.80 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $724.44 | Professional | None | $61.66 | $61.66 | $724.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $131.83 Median $478.63 Typical High $2,137.96 | Facility | None | $131.83 | $478.63 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $218.78 | Professional | None | $95.50 | $120.23 | $218.78 |
United Setting Professional Modifier None Typical Low $41.69 Median $74.13 Typical High $114.82 | Professional | None | $41.69 | $74.13 | $114.82 |
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 $41.69 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $41.69 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $16.60 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $95.50 Typical High $95.50 | Professional | 54 · Surgery only | $61.66 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $12.30 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.32 | $12.59 | $12.59 |
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
$69.18
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.