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 $194.98 Median $234.42 Typical High $234.42 | Facility | None | $194.98 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $295.12 | Professional | None | $194.98 | $194.98 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $186.21 | Professional | None | $123.03 | $154.88 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $181.97 Median $288.40 Typical High $380.19 | Facility | None | $181.97 | $288.40 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $263.03 | Professional | None | $109.65 | $194.98 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $58.88 Median $263.03 Typical High $363.08 | Facility | None | $58.88 | $263.03 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $588.84 Typical High $588.84 | Facility | None | $245.47 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $562.34 | Professional | None | $213.80 | $213.80 | $562.34 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $194.98 Median $309.03 Typical High $2,187.76 | Facility | None | $194.98 | $309.03 | $2,187.76 |
United Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $323.59 | Professional | None | $190.55 | $218.78 | $323.59 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Where Indiana sits
The same service costs 549.5 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· 36th of 51
$195
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.