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 $34.67 Median $34.67 Typical High $57.54 | Facility | None | $34.67 | $34.67 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $34.67 Typical High $34.67 | Professional | None | $33.88 | $34.67 | $34.67 |
Ambetter Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $45.71 Typical High $67.61 | Facility | None | $28.84 | $45.71 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $33.88 Typical High $37.15 | Professional | None | $26.30 | $33.88 | $37.15 |
CareSource Setting Facility Modifier None Typical Low $20.42 Median $30.20 Typical High $40.74 | Facility | None | $20.42 | $30.20 | $40.74 |
CareSource Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $85.11 Typical High $93.33 | Facility | None | $37.15 | $85.11 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $117.49 | Professional | None | $33.88 | $33.88 | $117.49 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $51.29 Median $72.44 Typical High $151.36 | Facility | None | $51.29 | $72.44 | $151.36 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $32.36 Median $120.23 Typical High $218.78 | Professional | None | $32.36 | $120.23 | $218.78 |
United Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $37.15 | Professional | None | $28.18 | $28.18 | $37.15 |
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 $16.98 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $16.98 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.76 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.39 | $3.47 | $3.47 |
Where Indiana sits
The same service costs 5.4 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· 33rd of 51
$33.88
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.