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 $107.15 Median $107.15 Typical High $245.47 | Facility | None | $107.15 | $107.15 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | None | $104.71 | $107.15 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $173.78 Typical High $239.88 | Facility | None | $120.23 | $173.78 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $141.25 | Professional | None | $104.71 | $120.23 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $144.54 Typical High $190.55 | Facility | None | $95.50 | $144.54 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $263.03 Typical High $288.40 | Facility | None | $125.89 | $263.03 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $173.78 Median $263.03 Typical High $602.56 | Facility | None | $173.78 | $263.03 | $602.56 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $281.84 | Professional | None | $107.15 | $190.55 | $281.84 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $158.49 | Professional | None | $120.23 | $120.23 | $158.49 |
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 $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $20.89 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $10.72 |
Where Indiana sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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· 32nd of 51
$107
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.