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 $75.86 Median $75.86 Typical High $154.88 | Facility | None | $75.86 | $75.86 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | None | $74.13 | $75.86 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $114.82 Typical High $151.36 | Facility | None | $75.86 | $114.82 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $144.54 | Professional | None | $74.13 | $75.86 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $158.49 | Facility | None | $79.43 | $117.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $204.17 Typical High $204.17 | Facility | None | $85.11 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $218.78 | Professional | None | $74.13 | $74.13 | $218.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $87.10 Median $158.49 Typical High $239.88 | Facility | None | $87.10 | $158.49 | $239.88 |
United Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $239.88 | Professional | None | $75.86 | $75.86 | $239.88 |
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 $37.15 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $37.15 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $14.79 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.41 | $7.59 | $7.59 |
Where Indiana sits
The same service costs 1.5 times more in Alaska than in Delaware. 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· 22nd of 51
$79.43
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.