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 $18.20 Median $18.20 Typical High $35.48 | Facility | None | $18.20 | $18.20 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $18.20 Typical High $18.20 | Professional | None | $17.78 | $18.20 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $17.38 Median $26.92 Typical High $35.48 | Facility | None | $17.38 | $26.92 | $35.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $17.78 Typical High $34.67 | Professional | None | $17.38 | $17.78 | $34.67 |
CareSource Setting Facility Modifier None Typical Low $18.20 Median $26.92 Typical High $36.31 | Facility | None | $18.20 | $26.92 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $48.98 Typical High $48.98 | Facility | None | $20.42 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $50.12 | Professional | None | $17.78 | $17.78 | $50.12 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $21.38 Median $35.48 Typical High $56.23 | Facility | None | $21.38 | $35.48 | $56.23 |
United Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $54.95 | Professional | None | $17.38 | $17.38 | $54.95 |
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 $8.91 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $8.91 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $3.55 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.78 | $1.82 | $1.82 |
Where Indiana sits
The same service costs 1.5 times more in Alaska than in Rhode Island. 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· 23rd of 51
$18.62
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.