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 $74.13 Median $74.13 Typical High $147.91 | Facility | None | $74.13 | $74.13 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $75.86 | Professional | None | $72.44 | $74.13 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $109.65 Typical High $147.91 | Facility | None | $75.86 | $109.65 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $114.82 | Professional | None | $72.44 | $74.13 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $104.71 Typical High $138.04 | Facility | None | $69.18 | $104.71 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $181.97 Typical High $199.53 | Facility | None | $79.43 | $181.97 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $234.42 | Professional | None | $72.44 | $72.44 | $234.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $954.99 | Facility | None | $138.04 | $165.96 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $16.22 Median $89.13 Typical High $125.89 | Professional | None | $16.22 | $89.13 | $125.89 |
United Setting Professional Modifier None Typical Low $29.51 Median $74.13 Typical High $147.91 | Professional | None | $29.51 | $74.13 | $147.91 |
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 $36.31 Median $37.15 Typical High $38.02 | Professional | 52 · Reduced service | $36.31 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.79 Typical High $15.14 | Professional | 53 · Discontinued | $14.45 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $11.22 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.41 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.24 | $7.41 | $7.59 |
Where Indiana sits
The same service costs 1.6 times more in Hawaii than in Virginia. 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· 27th 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.