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 $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $21.38 Typical High $21.38 | Professional | None | $14.13 | $21.38 | $21.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $19.95 | Facility | None | $10.23 | $10.23 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $25.70 | Professional | None | $10.23 | $10.23 | $25.70 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $37.15 | Facility | None | $36.31 | $36.31 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $14.45 | Facility | None | $8.71 | $8.71 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $123.03 | Professional | None | $10.47 | $10.47 | $123.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $22.39 Median $81.28 Typical High $2,137.96 | Facility | None | $22.39 | $81.28 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $16.22 Median $20.42 Typical High $37.15 | Professional | None | $16.22 | $20.42 | $37.15 |
United Setting Professional Modifier None Typical Low $7.08 Median $12.59 Typical High $20.89 | Professional | None | $7.08 | $12.59 | $20.89 |
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 $7.08 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $7.08 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $2.82 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.47 Median $16.22 Typical High $16.22 | Professional | 54 · Surgery only | $10.47 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $2.09 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.41 | $2.14 | $2.14 |
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
$12.02
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.