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 $17.78 Median $17.78 Typical High $30.90 | Facility | None | $17.78 | $17.78 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $25.70 Typical High $30.90 | Professional | None | $17.78 | $25.70 | $30.90 |
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 $15.14 Median $18.62 Typical High $28.84 | Professional | None | $15.14 | $18.62 | $28.84 |
CareSource Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $36.31 | Facility | None | $18.20 | $18.20 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $34.67 Typical High $66.07 | Facility | None | $21.38 | $34.67 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $45.71 Typical High $97.72 | Professional | None | $19.95 | $45.71 | $97.72 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $33.88 Median $61.66 Typical High $2,089.30 | Facility | None | $33.88 | $61.66 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $21.38 Median $37.15 Typical High $63.10 | Professional | None | $21.38 | $37.15 | $63.10 |
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 $16.98 Median $35.48 Typical High $60.26 | Professional | None | $16.98 | $35.48 | $60.26 |
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 $8.91 Median $12.59 Typical High $15.49 | Professional | 52 · Reduced service | $8.91 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $5.13 Typical High $6.17 | Professional | 53 · Discontinued | $3.55 | $5.13 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $3.80 Typical High $4.68 | Professional | 55 · Aftercare only | $2.69 | $3.80 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.51 Typical High $3.09 | Professional | 56 · Pre-op care only | $1.78 | $2.51 | $3.09 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Virginia. 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
$30.90
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.