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 $93.33 Median $107.15 Typical High $125.89 | Facility | None | $93.33 | $107.15 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $181.97 | Professional | None | $93.33 | $125.89 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $323.59 | Facility | None | $169.82 | $169.82 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $229.09 | Professional | None | $131.83 | $169.82 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $141.25 | Facility | None | $123.03 | $123.03 | $141.25 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $208.93 | Professional | None | $125.89 | $169.82 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $229.09 | Professional | None | $138.04 | $169.82 | $229.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $128.82 Median $912.01 Typical High $2,187.76 | Facility | None | $128.82 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $208.93 | Professional | None | $114.82 | $158.49 | $208.93 |
United Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $239.88 | Professional | None | $138.04 | $165.96 | $239.88 |
3 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 $63.10 Median $63.10 Typical High $79.43 | Professional | 52 · Reduced service | $63.10 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $23.99 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $15.85 |
Where Indiana sits
The same service costs 2.4 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· 39th of 51
$151
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.