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 $154.88 Median $154.88 Typical High $309.03 | Facility | None | $154.88 | $154.88 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $239.88 Typical High $323.59 | Facility | None | $100.00 | $239.88 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $128.82 | Professional | None | $52.48 | $52.48 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $38.02 Median $69.18 Typical High $75.86 | Facility | None | $38.02 | $69.18 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $446.68 Typical High $446.68 | Facility | None | $186.21 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $426.58 | Professional | None | $162.18 | $162.18 | $426.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $95.50 Median $245.47 Typical High $912.01 | Facility | None | $95.50 | $245.47 | $912.01 |
United Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $501.19 | Professional | None | $158.49 | $158.49 | $501.19 |
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 $77.62 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $15.49 |
Where Indiana sits
The same service costs 4.4 times more in Alaska than in Hawaii. 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· 46th of 51
$151
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.