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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $31.62 | Professional | None | $30.90 | $30.90 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $19.50 | Facility | None | $10.00 | $10.00 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $13.18 | Professional | None | $10.00 | $10.00 | $13.18 |
CareSource Setting Facility Modifier None Typical Low $10.00 Median $15.14 Typical High $19.95 | Facility | None | $10.00 | $15.14 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $91.20 Typical High $91.20 | Facility | None | $37.15 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $173.78 | Professional | None | $33.11 | $33.11 | $173.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $23.99 Median $912.01 Typical High $2,137.96 | Facility | None | $23.99 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $10.47 Median $26.30 Typical High $245.47 | Professional | None | $10.47 | $26.30 | $245.47 |
United Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
4 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 $15.49 Median $15.49 Typical High $15.85 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.46 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.79 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.24 |
Where Indiana sits
The same service costs 5.6 times more in Alaska than in North Carolina. 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· 46th of 51
$13.49
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.