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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $63.10 | Professional | None | $41.69 | $63.10 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $58.88 | Facility | None | $30.20 | $30.20 | $58.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $75.86 | Professional | None | $30.20 | $30.20 | $75.86 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $109.65 | Facility | None | $107.15 | $107.15 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $363.08 | Professional | None | $30.90 | $30.90 | $363.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $66.07 Median $239.88 Typical High $2,137.96 | Facility | None | $66.07 | $239.88 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $109.65 | Professional | None | $47.86 | $60.26 | $109.65 |
United Setting Professional Modifier None Typical Low $20.89 Median $37.15 Typical High $58.88 | Professional | None | $20.89 | $37.15 | $58.88 |
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 $20.89 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $20.89 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $8.32 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $47.86 Typical High $47.86 | Professional | 54 · Surgery only | $30.90 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $6.17 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.17 | $6.31 | $6.31 |
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
$35.48
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.