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 $41.69 Median $46.77 Typical High $56.23 | Facility | None | $41.69 | $46.77 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $70.79 | Professional | None | $41.69 | $54.95 | $70.79 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $114.82 | Professional | None | $89.13 | $89.13 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $151.36 | Facility | None | $79.43 | $79.43 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $93.33 | Professional | None | $67.61 | $79.43 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $70.79 Typical High $77.62 | Facility | None | $69.18 | $70.79 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $128.82 | Professional | None | $70.79 | $87.10 | $128.82 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $173.78 Median $239.88 Typical High $2,187.76 | Facility | None | $173.78 | $239.88 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $83.18 | Professional | None | $58.88 | $74.13 | $83.18 |
United Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $123.03 | Professional | None | $69.18 | $85.11 | $123.03 |
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 $27.54 Median $27.54 Typical High $36.31 | Professional | 52 · Reduced service | $27.54 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $10.72 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $7.24 |
Where Indiana sits
The same service costs 2.1 times more in Oregon 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· 48th of 51
$67.61
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.