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 $91.20 Median $125.89 Typical High $186.21 | Facility | None | $91.20 | $125.89 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | None | $89.13 | $91.20 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $138.04 Typical High $186.21 | Facility | None | $93.33 | $138.04 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $173.78 | Professional | None | $89.13 | $93.33 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $154.88 Typical High $204.17 | Facility | None | $102.33 | $154.88 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $245.47 | Facility | None | $97.72 | $97.72 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $416.87 | Professional | None | $89.13 | $89.13 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $162.18 Median $204.17 Typical High $309.03 | Facility | None | $162.18 | $204.17 | $309.03 |
United Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $288.40 | Professional | None | $93.33 | $93.33 | $288.40 |
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 $44.67 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $44.67 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.91 | $9.12 | $9.12 |
Where Indiana sits
The same service costs 5.9 times more in Alabama than in Florida. 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
$97.72
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.