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 $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $6.17 Typical High $6.17 | Professional | None | $4.07 | $6.17 | $6.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $5.75 | Facility | None | $2.95 | $2.95 | $5.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $7.41 | Professional | None | $2.95 | $2.95 | $7.41 |
CareSource Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.72 | Facility | None | $10.47 | $10.47 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $35.48 | Professional | None | $3.02 | $3.02 | $35.48 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $6.46 Median $23.44 Typical High $2,137.96 | Facility | None | $6.46 | $23.44 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $4.68 Median $5.89 Typical High $10.72 | Professional | None | $4.68 | $5.89 | $10.72 |
United Setting Professional Modifier None Typical Low $2.04 Median $3.63 Typical High $6.03 | Professional | None | $2.04 | $3.63 | $6.03 |
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 $2.04 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $2.04 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $0.81 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.02 Median $4.68 Typical High $4.68 | Professional | 54 · Surgery only | $3.02 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.93 Typical High $0.93 | Professional | 55 · Aftercare only | $0.62 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.41 | $0.62 | $0.62 |
Where Indiana sits
The same service costs 2.7 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
$3.47
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.