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 $69.18 Median $77.62 Typical High $93.33 | Facility | None | $69.18 | $77.62 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $120.23 | Professional | None | $69.18 | $85.11 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | None | $134.90 | $134.90 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $234.42 | Facility | None | $120.23 | $120.23 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $144.54 | Professional | None | $102.33 | $120.23 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $117.49 Typical High $128.82 | Facility | None | $114.82 | $117.49 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $208.93 | Professional | None | $109.65 | $131.83 | $208.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $2,187.76 | Facility | None | $288.40 | $398.11 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $134.90 | Professional | None | $95.50 | $120.23 | $134.90 |
United Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $181.97 | Professional | None | $104.71 | $131.83 | $181.97 |
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 $45.71 Median $45.71 Typical High $60.26 | Professional | 52 · Reduced service | $45.71 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $18.20 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $12.02 |
Where Indiana sits
The same service costs 2.1 times more in Wisconsin 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· 45th of 51
$107
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.