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 $60.26 Median $72.44 Typical High $91.20 | Facility | None | $60.26 | $72.44 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | None | $60.26 | $60.26 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $95.50 Typical High $125.89 | Facility | None | $58.88 | $95.50 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $93.33 | Professional | None | $52.48 | $52.48 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $81.28 Typical High $91.20 | Facility | None | $45.71 | $81.28 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $141.25 Typical High $141.25 | Facility | None | $57.54 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $177.83 | Professional | None | $51.29 | $51.29 | $177.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $25.70 Median $51.29 Typical High $81.28 | Facility | None | $25.70 | $51.29 | $81.28 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $199.53 | Professional | None | $63.10 | $63.10 | $199.53 |
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 $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Where Indiana sits
The same service costs 3.0 times more in Kansas than in South Carolina. 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· 30th of 51
$63.10
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.