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 $40.74 Median $60.26 Typical High $77.62 | Facility | None | $40.74 | $60.26 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $70.79 | Professional | None | $40.74 | $40.74 | $70.79 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $61.66 Typical High $81.28 | Facility | None | $42.66 | $61.66 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $46.77 Typical High $77.62 | Professional | None | $38.90 | $46.77 | $77.62 |
CareSource Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $67.61 | Facility | None | $37.15 | $37.15 | $67.61 |
CareSource Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $141.25 Typical High $141.25 | Facility | None | $57.54 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $87.10 | Professional | None | $51.29 | $51.29 | $87.10 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $45.71 Median $74.13 Typical High $117.49 | Facility | None | $45.71 | $74.13 | $117.49 |
United Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $77.62 | Professional | None | $45.71 | $51.29 | $77.62 |
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 $20.42 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.07 |
Where Indiana sits
The same service costs 6.0 times more in Arizona than in Rhode Island. 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· 10th 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.