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 $41.69 Median $41.69 Typical High $100.00 | Facility | None | $41.69 | $41.69 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $72.44 Typical High $100.00 | Facility | None | $50.12 | $72.44 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $89.13 | Professional | None | $41.69 | $50.12 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $95.50 Typical High $125.89 | Facility | None | $63.10 | $95.50 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $104.71 Typical High $114.82 | Facility | None | $57.54 | $104.71 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $239.88 | Professional | None | $41.69 | $41.69 | $239.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $83.18 Median $138.04 Typical High $223.87 | Facility | None | $83.18 | $138.04 | $223.87 |
United Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $158.49 | Professional | None | $50.12 | $54.95 | $158.49 |
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 $20.89 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.17 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.17 |
Where Indiana sits
The same service costs 3.9 times more in Wyoming than in Georgia. 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· 19th of 51
$52.48
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.