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 $38.90 Median $38.90 Typical High $79.43 | Facility | None | $38.90 | $38.90 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.90 Typical High $38.90 | Professional | None | $38.02 | $38.90 | $38.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $39.81 Median $60.26 Typical High $79.43 | Facility | None | $39.81 | $60.26 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $39.81 Typical High $50.12 | Professional | None | $38.02 | $39.81 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $54.95 Typical High $74.13 | Facility | None | $36.31 | $54.95 | $74.13 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $104.71 Typical High $104.71 | Facility | None | $53.70 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $43.65 | Professional | None | $38.02 | $38.02 | $43.65 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $74.13 Median $79.43 Typical High $125.89 | Facility | None | $74.13 | $79.43 | $125.89 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $109.65 | Professional | None | $39.81 | $50.12 | $109.65 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $52.48 | Professional | None | $39.81 | $39.81 | $52.48 |
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 $19.05 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.76 Typical High $7.76 | Professional | 53 · Discontinued | $7.59 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.80 | $3.89 | $3.89 |
Where Indiana sits
The same service costs 1.6 times more in Alaska 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· 27th of 51
$38.90
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.