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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $72.44 | Professional | None | $46.77 | $72.44 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $66.07 | Facility | None | $34.67 | $34.67 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $85.11 | Professional | None | $34.67 | $34.67 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Facility | None | $120.23 | $120.23 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $407.38 | Professional | None | $34.67 | $34.67 | $407.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $75.86 Median $269.15 Typical High $2,137.96 | Facility | None | $75.86 | $269.15 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $125.89 | Professional | None | $53.70 | $69.18 | $125.89 |
United Setting Professional Modifier None Typical Low $23.44 Median $41.69 Typical High $66.07 | Professional | None | $23.44 | $41.69 | $66.07 |
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 $23.44 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $23.44 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $9.33 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $53.70 Typical High $53.70 | Professional | 54 · Surgery only | $35.48 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $7.08 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.68 | $7.24 | $7.24 |
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
$39.81
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.