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 $39.81 Median $39.81 Typical High $79.43 | Facility | None | $39.81 | $39.81 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $72.44 Typical High $85.11 | Professional | None | $39.81 | $72.44 | $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 $35.48 Median $60.26 Typical High $72.44 | Professional | None | $35.48 | $60.26 | $72.44 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $125.89 | Facility | None | $44.67 | $44.67 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $109.65 Typical High $186.21 | Facility | None | $66.07 | $109.65 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $162.18 | Professional | None | $45.71 | $75.86 | $162.18 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $109.65 Median $229.09 Typical High $954.99 | Facility | None | $109.65 | $229.09 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $50.12 Median $95.50 Typical High $165.96 | Professional | None | $50.12 | $95.50 | $165.96 |
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 $38.90 Median $69.18 Typical High $125.89 | Professional | None | $38.90 | $69.18 | $125.89 |
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 $19.95 Median $35.48 Typical High $42.66 | Professional | 52 · Reduced service | $19.95 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $14.45 Typical High $16.98 | Professional | 53 · Discontinued | $7.94 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $10.72 Typical High $12.88 | Professional | 55 · Aftercare only | $6.03 | $10.72 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $7.24 Typical High $8.51 | Professional | 56 · Pre-op care only | $3.98 | $7.24 | $8.51 |
Where Indiana sits
The same service costs 3.9 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· 48th of 51
$64.57
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.