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 $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $15.49 Typical High $15.49 | Professional | None | $10.00 | $15.49 | $15.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $14.45 | Facility | None | $7.41 | $7.41 | $14.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $18.20 | Professional | None | $7.41 | $7.41 | $18.20 |
CareSource Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.92 | Facility | None | $26.30 | $26.30 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $89.13 | Professional | None | $7.59 | $7.59 | $89.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $16.22 Median $58.88 Typical High $2,137.96 | Facility | None | $16.22 | $58.88 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $11.75 Median $14.79 Typical High $26.92 | Professional | None | $11.75 | $14.79 | $26.92 |
United Setting Professional Modifier None Typical Low $5.13 Median $8.91 Typical High $15.14 | Professional | None | $5.13 | $8.91 | $15.14 |
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 $5.01 Median $7.76 Typical High $7.76 | Professional | 52 · Reduced service | $5.01 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $3.09 Typical High $3.09 | Professional | 53 · Discontinued | $2.04 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.59 Median $11.48 Typical High $11.48 | Professional | 54 · Surgery only | $7.59 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $2.29 Typical High $2.29 | Professional | 55 · Aftercare only | $1.51 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.55 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.00 | $1.55 | $1.55 |
Where Indiana sits
The same service costs 2.7 times more in Idaho 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
$8.51
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.