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 $64.57 Median $87.10 Typical High $151.36 | Facility | None | $64.57 | $87.10 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $100.00 | Professional | None | $64.57 | $85.11 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $151.36 | Professional | None | $91.20 | $107.15 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $218.78 | Facility | None | $112.20 | $112.20 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $125.89 | Professional | None | $74.13 | $107.15 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $138.04 Typical High $213.80 | Facility | None | $66.07 | $138.04 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $144.54 | Professional | None | $100.00 | $109.65 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $134.90 | Professional | None | $61.66 | $91.20 | $134.90 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $186.21 Median $323.59 Typical High $2,187.76 | Facility | None | $186.21 | $323.59 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $151.36 | Professional | None | $63.10 | $95.50 | $151.36 |
United Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $123.03 | Professional | None | $63.10 | $91.20 | $123.03 |
6 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 $32.36 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $32.36 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $9.55 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.51 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.46 | $8.51 | $10.00 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $107.15 Median $123.03 Typical High $144.54 | Professional | 25 · Same-day visit | $107.15 | $123.03 | $144.54 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $112.20 Median $144.54 Typical High $144.54 | Professional | GC · Resident with teaching physician | $112.20 | $144.54 | $144.54 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | SA · Nurse practitioner | $107.15 | $107.15 | $107.15 |
Where Indiana sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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· 31st 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.