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 $83.18 Median $109.65 Typical High $177.83 | Facility | None | $83.18 | $109.65 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $125.89 | Professional | None | $81.28 | $102.33 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $177.83 | Professional | None | $102.33 | $109.65 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $251.19 | Facility | None | $131.83 | $131.83 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $147.91 | Professional | None | $93.33 | $125.89 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $85.11 Median $165.96 Typical High $257.04 | Facility | None | $85.11 | $165.96 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $169.82 | Professional | None | $117.49 | $131.83 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $162.18 | Professional | None | $81.28 | $114.82 | $162.18 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $257.04 Median $389.05 Typical High $2,187.76 | Facility | None | $257.04 | $389.05 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $186.21 | Professional | None | $81.28 | $125.89 | $186.21 |
United Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $147.91 | Professional | None | $81.28 | $112.20 | $147.91 |
5 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 $40.74 Median $50.12 Typical High $58.88 | Professional | 52 · Reduced service | $40.74 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.00 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.13 | $10.00 | $11.75 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $109.65 Median $151.36 Typical High $177.83 | Professional | 25 · Same-day visit | $109.65 | $151.36 | $177.83 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $128.82 Median $128.82 Typical High $162.18 | Professional | GC · Resident with teaching physician | $128.82 | $128.82 | $162.18 |
Where Indiana sits
The same service costs 2.7 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· 35th of 51
$117
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.