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 $85.11 Median $114.82 Typical High $173.78 | Facility | None | $85.11 | $114.82 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $120.23 | Professional | None | $77.62 | $85.11 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | None | $95.50 | $95.50 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $338.84 Typical High $5,888.44 | Facility | None | $165.96 | $338.84 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $186.21 | Professional | None | $97.72 | $165.96 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $109.65 | Facility | None | $95.50 | $95.50 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $165.96 | Professional | None | $109.65 | $120.23 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $10,000.00 Typical High $10,000.00 | Facility | None | $3,311.31 | $10,000.00 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $186.21 | Professional | None | $102.33 | $117.49 | $186.21 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $288.40 Median $371.54 Typical High $2,187.76 | Facility | None | $288.40 | $371.54 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $194.98 | Professional | None | $87.10 | $117.49 | $194.98 |
United Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $158.49 | Professional | None | $100.00 | $117.49 | $158.49 |
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 $38.90 Median $42.66 Typical High $51.29 | Professional | 52 · Reduced service | $38.90 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.88 Typical High $15.49 | Professional | 55 · Aftercare only | $11.48 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.51 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.76 | $8.51 | $10.23 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $95.50 Typical High $141.25 | Professional | 25 · Same-day visit | $95.50 | $95.50 | $141.25 |
Where Indiana sits
The same service costs 2.7 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· 30th of 51
$123
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.