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 $51.29 Median $51.29 Typical High $89.13 | Facility | None | $51.29 | $51.29 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $75.86 | Professional | None | $51.29 | $51.29 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $45.71 | Professional | None | $33.11 | $38.90 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $44.67 Median $72.44 Typical High $95.50 | Facility | None | $44.67 | $72.44 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $66.07 | Professional | None | $32.36 | $48.98 | $66.07 |
CareSource Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $38.90 | Facility | None | $21.88 | $21.88 | $38.90 |
CareSource Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $147.91 Typical High $147.91 | Facility | None | $60.26 | $147.91 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $131.83 | Professional | None | $53.70 | $53.70 | $131.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $47.86 Median $75.86 Typical High $2,187.76 | Facility | None | $47.86 | $75.86 | $2,187.76 |
United Setting Professional Modifier None Typical Low $46.77 Median $52.48 Typical High $79.43 | Professional | None | $46.77 | $52.48 | $79.43 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |
Where Indiana sits
The same service costs 1.5 times more in Colorado than in Alaska. 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· 39th of 51
$51.29
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.