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 $64.57 Median $79.43 Typical High $114.82 | Facility | None | $64.57 | $79.43 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | None | $77.62 | $79.43 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $93.33 Typical High $154.88 | Facility | None | $70.79 | $93.33 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $104.71 | Professional | None | $46.77 | $77.62 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $39.81 Median $58.88 Typical High $79.43 | Facility | None | $39.81 | $58.88 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $213.80 Typical High $213.80 | Facility | None | $87.10 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $109.65 | Professional | None | $77.62 | $77.62 | $109.65 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $64.57 Median $117.49 Typical High $173.78 | Facility | None | $64.57 | $117.49 | $173.78 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $147.91 | Professional | None | $46.77 | $46.77 | $147.91 |
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 $38.90 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.49 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.76 | $7.94 | $7.94 |
Where Indiana sits
The same service costs 3.6 times more in Texas than in Kansas. 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
$77.62
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.