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 $100.00 Median $134.90 Typical High $204.17 | Facility | None | $100.00 | $134.90 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $144.54 | Professional | None | $97.72 | $120.23 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $186.21 | Professional | None | $125.89 | $147.91 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $309.03 | Facility | None | $162.18 | $162.18 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $181.97 | Professional | None | $104.71 | $154.88 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $204.17 Typical High $316.23 | Facility | None | $102.33 | $204.17 | $316.23 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $199.53 | Professional | None | $138.04 | $151.36 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $186.21 | Professional | None | $95.50 | $131.83 | $186.21 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $309.03 Median $912.01 Typical High $2,187.76 | Facility | None | $309.03 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $208.93 | Professional | None | $95.50 | $141.25 | $208.93 |
United Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $173.78 | Professional | None | $100.00 | $131.83 | $173.78 |
4 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 $50.12 Median $57.54 Typical High $67.61 | Professional | 52 · Reduced service | $50.12 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $14.79 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.48 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.00 | $11.48 | $13.49 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $117.49 Median $147.91 Typical High $204.17 | Professional | 25 · Same-day visit | $117.49 | $147.91 | $204.17 |
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· 31st of 51
$138
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.