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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $346.74 | Professional | None | $229.09 | $229.09 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $218.78 | Professional | None | $131.83 | $131.83 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $338.84 Typical High $446.68 | Facility | None | $213.80 | $338.84 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $309.03 | Professional | None | $125.89 | $229.09 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $234.42 | Facility | None | $128.82 | $128.82 | $234.42 |
CareSource Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $691.83 Typical High $691.83 | Facility | None | $288.40 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $588.84 | Professional | None | $251.19 | $251.19 | $588.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $2,089.30 | Facility | None | $208.93 | $331.13 | $2,089.30 |
United Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $380.19 | Professional | None | $223.87 | $257.04 | $380.19 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Where Indiana sits
The same service costs 2.0 times more in Arizona than in Alabama. 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· 37th of 51
$229
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.