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 $85.11 Median $85.11 Typical High $162.18 | Facility | None | $85.11 | $85.11 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | None | $83.18 | $85.11 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $125.89 Typical High $169.82 | Facility | None | $81.28 | $125.89 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $83.18 Typical High $158.49 | Professional | None | $81.28 | $83.18 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $120.23 Typical High $162.18 | Facility | None | $81.28 | $120.23 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $229.09 Typical High $229.09 | Facility | None | $95.50 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $213.80 | Professional | None | $83.18 | $83.18 | $213.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $79.43 Median $162.18 Typical High $257.04 | Facility | None | $79.43 | $162.18 | $257.04 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $257.04 | Professional | None | $81.28 | $81.28 | $257.04 |
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 $41.69 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $41.69 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.32 | $8.51 | $8.51 |
Where Indiana sits
The same service costs 1.5 times more in Arizona than in Nebraska. 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· 16th of 51
$85.11
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.