How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $44.67 | Professional | None | $28.84 | $30.90 | $44.67 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $97.72 | Facility | None | $50.12 | $50.12 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $50.12 Typical High $67.61 | Professional | None | $30.90 | $50.12 | $67.61 |
CareSource Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $37.15 | Facility | None | $32.36 | $32.36 | $37.15 |
CareSource Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $53.70 Typical High $89.13 | Professional | None | $38.02 | $53.70 | $89.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $93.33 Median $912.01 Typical High $2,187.76 | Facility | None | $93.33 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $30.90 Median $40.74 Typical High $53.70 | Professional | None | $30.90 | $40.74 | $53.70 |
United Setting Professional Modifier None Typical Low $42.66 Median $52.48 Typical High $75.86 | Professional | None | $42.66 | $52.48 | $75.86 |
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 $14.13 Median $15.49 Typical High $19.50 | Professional | 52 · Reduced service | $14.13 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.57 Typical High $5.75 | Professional | 55 · Aftercare only | $4.27 | $4.57 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.09 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.88 | $3.09 | $3.89 |
Where Indiana sits
The same service costs 2.6 times more in Nebraska than in Texas. 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· 33rd of 51
$50.12
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.