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 $16.98 Median $25.12 Typical High $5,495.41 | Facility | None | $16.98 | $25.12 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $16.98 Typical High $34.67 | Professional | None | $16.60 | $16.98 | $34.67 |
Ambetter Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $46.77 | Facility | None | $23.99 | $23.99 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $23.99 Typical High $35.48 | Professional | None | $17.78 | $23.99 | $35.48 |
CareSource Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
CareSource Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $19.05 | Professional | None | $16.22 | $16.22 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $21.88 Typical High $31.62 | Professional | None | $17.78 | $21.88 | $31.62 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $14.45 Median $53.70 Typical High $2,187.76 | Facility | None | $14.45 | $53.70 | $2,187.76 |
United Setting Professional Modifier None Typical Low $17.78 Median $24.55 Typical High $41.69 | Professional | None | $17.78 | $24.55 | $41.69 |
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 $8.32 Median $8.51 Typical High $9.55 | Professional | 52 · Reduced service | $8.32 | $8.51 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.47 Typical High $3.80 | Professional | 53 · Discontinued | $3.31 | $3.47 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.57 Typical High $2.88 | Professional | 55 · Aftercare only | $2.45 | $2.57 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.74 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.66 | $1.74 | $1.91 |
Where Indiana sits
The same service costs 40.7 times more in Tennessee than in New York. 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· 40th of 51
$23.99
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.