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 $67.61 Median $93.33 Typical High $138.04 | Facility | None | $67.61 | $93.33 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $69.18 | Professional | None | $67.61 | $67.61 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $102.33 Typical High $134.90 | Facility | None | $67.61 | $102.33 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $128.82 | Professional | None | $67.61 | $67.61 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $114.82 Typical High $151.36 | Facility | None | $75.86 | $114.82 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $181.97 Typical High $323.59 | Facility | None | $75.86 | $181.97 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $389.05 | Professional | None | $67.61 | $67.61 | $389.05 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $70.79 Median $144.54 Typical High $213.80 | Facility | None | $70.79 | $144.54 | $213.80 |
United Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $213.80 | Professional | None | $67.61 | $67.61 | $213.80 |
5 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 $33.11 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.11 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Ambetter Setting Professional Modifier JA · Given by IV Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | JA · Given by IV | $67.61 | $67.61 | $67.61 |
Where Indiana sits
The same service costs 2.0 times more in Oklahoma than in New Mexico. 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
$74.13
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.