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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $51.29 | Professional | None | $42.66 | $42.66 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $50.12 | Facility | None | $0.02 | $0.02 | $50.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $89.13 | Professional | None | $50.12 | $50.12 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $40.74 Median $75.86 Typical High $117.49 | Facility | None | $40.74 | $75.86 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $128.82 Typical High $128.82 | Professional | None | $38.90 | $128.82 | $128.82 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $67.61 Median $912.01 Typical High $2,290.87 | Facility | None | $67.61 | $912.01 | $2,290.87 |
United Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $85.11 | Professional | None | $50.12 | $50.12 | $85.11 |
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 $21.38 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Where Indiana sits
The same service costs 2.0 times more in Oregon 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· 19th of 51
$50.12
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.