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 $31.62 Median $46.77 Typical High $69.18 | Facility | None | $31.62 | $46.77 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.11 Median $51.29 Typical High $67.61 | Facility | None | $33.11 | $51.29 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $61.66 | Professional | None | $31.62 | $33.88 | $61.66 |
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 $43.65 Median $87.10 Typical High $87.10 | Facility | None | $43.65 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $100.00 | Professional | None | $31.62 | $31.62 | $100.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $57.54 Median $74.13 Typical High $107.15 | Facility | None | $57.54 | $74.13 | $107.15 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $107.15 | Professional | None | $33.88 | $33.88 | $107.15 |
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 $15.85 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.68 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.16 |
Where Indiana sits
The same service costs 2.3 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· 26th of 51
$34.67
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.