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 $58.88 Median $85.11 Typical High $134.90 | Facility | None | $58.88 | $85.11 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $89.13 | Professional | None | $58.88 | $77.62 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $134.90 | Professional | None | $79.43 | $97.72 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $194.98 | Facility | None | $100.00 | $100.00 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $112.20 | Professional | None | $67.61 | $97.72 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $117.49 Typical High $181.97 | Facility | None | $60.26 | $117.49 | $181.97 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $128.82 | Professional | None | $89.13 | $100.00 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $123.03 | Professional | None | $54.95 | $75.86 | $123.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $169.82 Median $295.12 Typical High $2,187.76 | Facility | None | $169.82 | $295.12 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $134.90 | Professional | None | $57.54 | $87.10 | $134.90 |
United Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $109.65 | Professional | None | $57.54 | $79.43 | $109.65 |
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 $28.84 Median $38.02 Typical High $44.67 | Professional | 52 · Reduced service | $28.84 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $11.48 Typical High $13.49 | Professional | 55 · Aftercare only | $8.71 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.59 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.89 | $7.59 | $8.91 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $83.18 Median $107.15 Typical High $131.83 | Professional | 25 · Same-day visit | $83.18 | $107.15 | $131.83 |
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· 28th of 51
$89.13
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.