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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | None | $120.23 | $120.23 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $186.21 Typical High $245.47 | Facility | None | $123.03 | $186.21 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $117.49 Typical High $158.49 | Professional | None | $47.86 | $117.49 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $27.54 Median $30.90 Typical High $56.23 | Facility | None | $27.54 | $30.90 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $380.19 Typical High $380.19 | Facility | None | $154.88 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $331.13 | Professional | None | $138.04 | $138.04 | $331.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $114.82 Median $190.55 Typical High $2,187.76 | Facility | None | $114.82 | $190.55 | $2,187.76 |
United Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $199.53 | Professional | None | $117.49 | $131.83 | $199.53 |
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 $60.26 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Where Indiana sits
The same service costs 5.1 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· 29th of 51
$120
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.