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 $72.44 Median $72.44 Typical High $144.54 | Facility | None | $72.44 | $72.44 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $112.20 Typical High $151.36 | Facility | None | $70.79 | $112.20 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $100.00 | Professional | None | $56.23 | $56.23 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $48.98 Median $87.10 Typical High $97.72 | Facility | None | $48.98 | $87.10 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $213.80 Typical High $213.80 | Facility | None | $87.10 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $154.88 | Professional | None | $77.62 | $77.62 | $154.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $74.13 Median $173.78 Typical High $2,137.96 | Facility | None | $74.13 | $173.78 | $2,137.96 |
United Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $239.88 | Professional | None | $75.86 | $75.86 | $239.88 |
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 $36.31 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.24 |
Where Indiana sits
The same service costs 25.1 times more in Alabama than in Nebraska. 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· 41st of 51
$75.86
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.