How much rates vary
Facilitymedian $44 · 10th to 90th $26 to $98Professionalmedian $60 · 10th to 90th $34 to $79
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 $26.30 Median $38.90 Typical High $63.10 | Facility | None | $26.30 | $38.90 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $40.74 Typical High $61.66 | Professional | None | $27.54 | $40.74 | $61.66 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $93.33 | Professional | None | $42.66 | $70.79 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $147.91 | Facility | None | $74.13 | $74.13 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $75.86 | Professional | None | $47.86 | $66.07 | $75.86 |
CareSource Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $47.86 | Facility | None | $41.69 | $41.69 | $47.86 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $93.33 | Professional | None | $64.57 | $72.44 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $162.18 | Facility | None | $100.00 | $120.23 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $93.33 | Professional | None | $47.86 | $63.10 | $93.33 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $97.72 Median $177.83 Typical High $2,089.30 | Facility | None | $97.72 | $177.83 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $39.81 Median $61.66 Typical High $97.72 | Professional | None | $39.81 | $61.66 | $97.72 |
United Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $83.18 | Professional | None | $44.67 | $61.66 | $83.18 |
10 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 Facility Modifier 52 · Reduced service Typical Low $17.38 Median $21.88 Typical High $27.54 | Facility | 52 · Reduced service | $17.38 | $21.88 | $27.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.13 Median $6.61 Typical High $8.32 | Facility | 55 · Aftercare only | $5.13 | $6.61 | $8.32 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.37 Typical High $5.50 | Facility | 56 · Pre-op care only | $3.47 | $4.37 | $5.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $25.12 Typical High $30.90 | Professional | 52 · Reduced service | $17.38 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $7.59 Typical High $9.33 | Professional | 55 · Aftercare only | $5.13 | $7.59 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.13 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.47 | $5.13 | $6.17 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $38.90 Median $70.79 Typical High $91.20 | Professional | 25 · Same-day visit | $38.90 | $70.79 | $91.20 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 93 · Audio-only telehealth | $33.11 | $33.11 | $33.11 |
Ambetter Setting Professional Modifier CG · Policy criteria applied Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CG · Policy criteria applied | $70.79 | $70.79 | $70.79 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | GC · Resident with teaching physician | $70.79 | $70.79 | $70.79 |
Where Indiana sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 39th of 51
$60.26
AK $107NJ $48.98
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.