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 $54.95 Median $74.13 Typical High $109.65 | Facility | None | $54.95 | $74.13 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $57.54 Median $83.18 Typical High $109.65 | Facility | None | $57.54 | $83.18 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $107.15 | Professional | None | $54.95 | $54.95 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $89.13 Typical High $120.23 | Facility | None | $60.26 | $89.13 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $151.36 Typical High $151.36 | Facility | None | $61.66 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $131.83 | Professional | None | $54.95 | $54.95 | $131.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $173.78 | Facility | None | $81.28 | $114.82 | $173.78 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $173.78 | Professional | None | $54.95 | $54.95 | $173.78 |
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 $27.54 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $10.96 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.50 |
Where Indiana sits
The same service costs 2.7 times more in Oklahoma than in West Virginia. 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· 18th of 51
$60.26
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.