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 $43.65 Median $43.65 Typical High $87.10 | Facility | None | $43.65 | $43.65 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $64.57 Typical High $87.10 | Facility | None | $42.66 | $64.57 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $83.18 | Professional | None | $42.66 | $43.65 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $41.69 Median $63.10 Typical High $83.18 | Facility | None | $41.69 | $63.10 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $100.00 Typical High $120.23 | Facility | None | $60.26 | $100.00 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $54.95 | Professional | None | $42.66 | $42.66 | $54.95 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $40.74 Median $83.18 Typical High $120.23 | Facility | None | $40.74 | $83.18 | $120.23 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $134.90 | Professional | None | $42.66 | $42.66 | $134.90 |
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 $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
Where Indiana sits
The same service costs 1.6 times more in Arizona than in Maryland. 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· 33rd of 51
$43.65
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.