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 $75.86 Median $91.20 Typical High $112.20 | Facility | None | $75.86 | $91.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $131.83 | Professional | None | $75.86 | $75.86 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | None | $63.10 | $63.10 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $151.36 | Facility | None | $81.28 | $114.82 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $147.91 | Professional | None | $74.13 | $85.11 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $131.83 | Facility | None | $74.13 | $74.13 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $257.04 Typical High $257.04 | Facility | None | $107.15 | $257.04 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $251.19 | Professional | None | $93.33 | $93.33 | $251.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $91.20 Median $147.91 Typical High $223.87 | Facility | None | $91.20 | $147.91 | $223.87 |
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 $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Where Indiana sits
The same service costs 2.9 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· 20th of 51
$93.33
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.