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 $28.84 Median $28.84 Typical High $50.12 | Facility | None | $28.84 | $28.84 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.18 Median $43.65 Typical High $57.54 | Facility | None | $28.18 | $43.65 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $33.11 | Professional | None | $24.55 | $28.84 | $33.11 |
CareSource Setting Facility Modifier None Typical Low $21.88 Median $32.36 Typical High $43.65 | Facility | None | $21.88 | $32.36 | $43.65 |
CareSource Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $79.43 Typical High $79.43 | Facility | None | $40.74 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $67.61 | Professional | None | $28.84 | $28.84 | $67.61 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $39.81 Median $52.48 Typical High $79.43 | Facility | None | $39.81 | $52.48 | $79.43 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $23.44 Median $53.70 Typical High $72.44 | Professional | None | $23.44 | $53.70 | $72.44 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $32.36 | Professional | None | $24.55 | $24.55 | $32.36 |
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 $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.88 |
Where Indiana sits
The same service costs 2.8 times more in Wyoming than in Arizona. 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· 10th of 51
$28.84
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.