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 $70.79 Median $81.28 Typical High $102.33 | Facility | None | $70.79 | $81.28 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $154.88 | Professional | None | $70.79 | $95.50 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $131.83 | Professional | None | $95.50 | $112.20 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $190.55 | Facility | None | $97.72 | $97.72 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $151.36 | Professional | None | $83.18 | $97.72 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $131.83 | Facility | None | $117.49 | $117.49 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | None | $120.23 | $120.23 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $162.18 | Professional | None | $83.18 | $102.33 | $162.18 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $173.78 Median $398.11 Typical High $2,137.96 | Facility | None | $173.78 | $398.11 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $128.82 | Professional | None | $107.15 | $109.65 | $128.82 |
United Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $162.18 | Professional | None | $74.13 | $104.71 | $162.18 |
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 $46.77 Median $47.86 Typical High $56.23 | Professional | 52 · Reduced service | $46.77 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $16.98 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.55 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.33 | $9.55 | $11.22 |
Where Indiana sits
The same service costs 2.9 times more in Alaska than in Ohio. 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· 41st of 51
$97.72
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.