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 $89.13 Median $114.82 Typical High $154.88 | Facility | None | $89.13 | $114.82 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $125.89 | Professional | None | $85.11 | $89.13 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | None | $107.15 | $109.65 | $109.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $177.83 | Professional | None | $83.18 | $131.83 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,238.72 Typical High $3,801.89 | Facility | None | $446.68 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $208.93 | Professional | None | $102.33 | $120.23 | $208.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $263.03 Median $3,548.13 Typical High $4,570.88 | Facility | None | $263.03 | $3,548.13 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $173.78 | Professional | None | $100.00 | $120.23 | $173.78 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $181.97 | Professional | None | $93.33 | $123.03 | $181.97 |
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 $41.69 Median $44.67 Typical High $53.70 | Professional | 52 · Reduced service | $41.69 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.78 Typical High $21.88 | Professional | 53 · Discontinued | $16.60 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.18 Typical High $16.22 | Professional | 55 · Aftercare only | $12.30 | $13.18 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.91 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.32 | $8.91 | $10.96 |
Where Indiana sits
The same service costs 7.9 times more in Kansas 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· 41st of 51
$132
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.