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 $70.79 Median $97.72 Typical High $134.90 | Facility | None | $70.79 | $97.72 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $72.44 | Professional | None | $70.79 | $70.79 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $109.65 Typical High $147.91 | Facility | None | $74.13 | $109.65 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $93.33 | Professional | None | $70.79 | $74.13 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $134.90 | Facility | None | $75.86 | $75.86 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $83.18 | Professional | None | $75.86 | $75.86 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $173.78 Typical High $194.98 | Facility | None | $97.72 | $173.78 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $125.89 | Professional | None | $70.79 | $70.79 | $125.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $141.25 Median $151.36 Typical High $234.42 | Facility | None | $141.25 | $151.36 | $234.42 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $181.97 | Professional | None | $69.18 | $97.72 | $181.97 |
United Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $97.72 | Professional | None | $74.13 | $74.13 | $97.72 |
5 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 $35.48 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.08 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | JW · Drug discarded | $74.13 | $74.13 | $74.13 |
Where Indiana sits
The same service costs 1.5 times more in Wyoming than in Florida. 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· 39th of 51
$72.44
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.