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 $72.44 Median $97.72 Typical High $158.49 | Facility | None | $72.44 | $97.72 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $109.65 | Professional | None | $72.44 | $91.20 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $158.49 | Professional | None | $95.50 | $112.20 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $239.88 | Facility | None | $123.03 | $123.03 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $141.25 | Professional | None | $85.11 | $117.49 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $158.49 Typical High $245.47 | Facility | None | $74.13 | $158.49 | $245.47 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $151.36 | Professional | None | $104.71 | $114.82 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $141.25 | Professional | None | $70.79 | $95.50 | $141.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $213.80 Median $338.84 Typical High $2,187.76 | Facility | None | $213.80 | $338.84 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $158.49 | Professional | None | $70.79 | $104.71 | $158.49 |
United Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $131.83 | Professional | None | $72.44 | $95.50 | $131.83 |
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 $36.31 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $36.31 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $10.96 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.24 | $8.91 | $10.47 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $131.83 Typical High $158.49 | Professional | 25 · Same-day visit | $95.50 | $131.83 | $158.49 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $107.15 Median $144.54 Typical High $144.54 | Professional | GC · Resident with teaching physician | $107.15 | $144.54 | $144.54 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | GE · Resident, primary care exception | $151.36 | $151.36 | $151.36 |
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· 28th of 51
$107
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.