How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $38.02 Median $64.57 Typical High $158.49 | Facility | None | $38.02 | $64.57 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $63.10 Typical High $75.86 | Professional | None | $38.02 | $63.10 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $100.00 | Professional | None | $44.67 | $70.79 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $46.77 Median $616.60 Typical High $912.01 | Facility | None | $46.77 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $125.89 | Professional | None | $46.77 | $72.44 | $125.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $117.49 Median $288.40 Typical High $2,089.30 | Facility | None | $117.49 | $288.40 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $47.86 Median $79.43 Typical High $112.20 | Professional | None | $47.86 | $79.43 | $112.20 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $41.69 Median $64.57 Typical High $107.15 | Professional | None | $41.69 | $64.57 | $107.15 |
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 $19.05 Median $28.18 Typical High $36.31 | Professional | 52 · Reduced service | $19.05 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $11.22 Typical High $14.45 | Professional | 53 · Discontinued | $7.59 | $11.22 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.32 Typical High $10.96 | Professional | 55 · Aftercare only | $5.75 | $8.32 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.62 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.80 | $5.62 | $7.24 |
Where Indiana sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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· 36th of 51
$70.79
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.