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 $104.71 Typical High $131.83 | Facility | None | $75.86 | $104.71 | $131.83 |
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 $57.54 Median $64.57 Typical High $75.86 | Professional | None | $57.54 | $64.57 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $112.20 Typical High $151.36 | Facility | None | $75.86 | $112.20 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $134.90 | Professional | None | $74.13 | $74.13 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $125.89 | Facility | None | $70.79 | $70.79 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $204.17 Typical High $223.87 | Facility | None | $89.13 | $204.17 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $213.80 | Professional | None | $81.28 | $81.28 | $213.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $74.13 Median $141.25 Typical High $229.09 | Facility | None | $74.13 | $141.25 | $229.09 |
United Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $123.03 | Professional | None | $72.44 | $81.28 | $123.03 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
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 $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
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 2.8 times more in Alaska 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· 31st of 51
$81.28
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.