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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $36.31 Typical High $36.31 | Professional | None | $23.99 | $36.31 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $33.88 | Facility | None | $17.38 | $17.38 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $43.65 | Professional | None | $17.38 | $17.38 | $43.65 |
CareSource Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $64.57 | Facility | None | $61.66 | $61.66 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $208.93 | Professional | None | $17.78 | $17.78 | $208.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $38.02 Median $138.04 Typical High $2,137.96 | Facility | None | $38.02 | $138.04 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $63.10 | Professional | None | $27.54 | $35.48 | $63.10 |
United Setting Professional Modifier None Typical Low $12.02 Median $21.38 Typical High $35.48 | Professional | None | $12.02 | $21.38 | $35.48 |
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 $12.02 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $12.02 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $4.79 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $27.54 Typical High $27.54 | Professional | 54 · Surgery only | $17.78 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $3.63 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.40 | $3.63 | $3.63 |
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· 45th of 51
$20.42
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.