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 $51.29 Median $51.29 Typical High $104.71 | Facility | None | $51.29 | $51.29 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $81.28 Typical High $107.15 | Facility | None | $51.29 | $81.28 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $63.10 | Professional | None | $35.48 | $35.48 | $63.10 |
CareSource Setting Facility Modifier None Typical Low $7.94 Median $14.45 Typical High $15.85 | Facility | None | $7.94 | $14.45 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $151.36 Typical High $151.36 | Facility | None | $61.66 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $151.36 | Professional | None | $54.95 | $54.95 | $151.36 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $32.36 Median $87.10 Typical High $93.33 | Facility | None | $32.36 | $87.10 | $93.33 |
United Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $169.82 | Professional | None | $53.70 | $53.70 | $169.82 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |
Where Indiana sits
The same service costs 2.2 times more in Alaska than in Montana. 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· 42nd of 51
$53.70
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.