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 $11.22 Median $16.22 Typical High $19.50 | Facility | None | $11.22 | $16.22 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $11.22 Typical High $11.75 | Professional | None | $10.96 | $11.22 | $11.75 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $16.98 Typical High $22.39 | Facility | None | $11.22 | $16.98 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $11.22 Typical High $21.38 | Professional | None | $10.96 | $11.22 | $21.38 |
CareSource Setting Facility Modifier None Typical Low $10.96 Median $16.60 Typical High $21.88 | Facility | None | $10.96 | $16.60 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $30.20 Typical High $45.71 | Facility | None | $12.59 | $30.20 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $30.20 | Professional | None | $10.96 | $10.96 | $30.20 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $21.38 Median $30.90 Typical High $954.99 | Facility | None | $21.38 | $30.90 | $954.99 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $35.48 | Professional | None | $11.22 | $11.22 | $35.48 |
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 $5.50 Median $5.62 Typical High $5.62 | Professional | 52 · Reduced service | $5.50 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.24 Typical High $2.24 | Professional | 53 · Discontinued | $2.19 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.10 | $1.12 | $1.12 |
Where Indiana sits
The same service costs 302.0 times more in Alabama 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· 20th of 51
$12.30
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.