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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $28.84 Typical High $28.84 | Professional | None | $19.05 | $28.84 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $26.92 | Facility | None | $13.80 | $13.80 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $34.67 | Professional | None | $13.80 | $13.80 | $34.67 |
CareSource Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $50.12 | Facility | None | $48.98 | $48.98 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $19.50 | Facility | None | $11.75 | $11.75 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $165.96 | Professional | None | $14.13 | $14.13 | $165.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $30.20 Median $109.65 Typical High $2,137.96 | Facility | None | $30.20 | $109.65 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $21.88 Median $27.54 Typical High $50.12 | Professional | None | $21.88 | $27.54 | $50.12 |
United Setting Professional Modifier None Typical Low $9.55 Median $16.98 Typical High $28.18 | Professional | None | $9.55 | $16.98 | $28.18 |
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 $9.55 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $9.55 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $3.80 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $21.88 Typical High $21.88 | Professional | 54 · Surgery only | $14.13 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $2.82 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.91 | $2.88 | $2.88 |
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· 43rd of 51
$16.22
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.