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 $32.36 Median $47.86 Typical High $60.26 | Facility | None | $32.36 | $47.86 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | None | $31.62 | $32.36 | $32.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.11 Median $47.86 Typical High $63.10 | Facility | None | $33.11 | $47.86 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $60.26 | Professional | None | $31.62 | $31.62 | $60.26 |
CareSource Setting Facility Modifier None Typical Low $32.36 Median $47.86 Typical High $64.57 | Facility | None | $32.36 | $47.86 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $87.10 Typical High $87.10 | Facility | None | $35.48 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $154.88 | Professional | None | $31.62 | $31.62 | $154.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $95.50 | Facility | None | $60.26 | $63.10 | $95.50 |
United Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $100.00 | Professional | None | $31.62 | $31.62 | $100.00 |
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 $15.85 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $15.85 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.31 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.16 | $3.24 | $3.24 |
Where Indiana sits
The same service costs 3.8 times more in Alabama 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· 24th of 51
$33.11
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.