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 $21.38 Median $21.38 Typical High $44.67 | Facility | None | $21.38 | $21.38 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $21.38 | Professional | None | $20.89 | $21.38 | $21.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.88 Median $33.11 Typical High $43.65 | Facility | None | $21.88 | $33.11 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $40.74 | Professional | None | $20.89 | $21.88 | $40.74 |
CareSource Setting Facility Modifier None Typical Low $21.88 Median $33.11 Typical High $43.65 | Facility | None | $21.88 | $33.11 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $52.48 Typical High $57.54 | Facility | None | $23.99 | $52.48 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $57.54 | Professional | None | $20.89 | $20.89 | $57.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $34.67 Median $41.69 Typical High $69.18 | Facility | None | $34.67 | $41.69 | $69.18 |
United Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $69.18 | Professional | None | $21.88 | $21.88 | $69.18 |
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 $10.47 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $10.47 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.09 | $2.14 | $2.14 |
Where Indiana sits
The same service costs 2.6 times more in Wyoming than in Texas. 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· 16th of 51
$23.44
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.