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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $173.78 | Facility | None | $81.28 | $128.82 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $208.93 | Professional | None | $104.71 | $114.82 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $169.82 | Facility | None | $85.11 | $93.33 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $263.03 Typical High $263.03 | Facility | None | $107.15 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $257.04 | Professional | None | $95.50 | $95.50 | $257.04 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $87.10 Median $186.21 Typical High $2,187.76 | Facility | None | $87.10 | $186.21 | $2,187.76 |
United Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $144.54 | Professional | None | $85.11 | $95.50 | $144.54 |
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 $43.65 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
Where Indiana sits
The same service costs 1.7 times more in Texas than in Arkansas. 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· 9th of 51
$115
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.