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 $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | None | $70.79 | $72.44 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $181.97 Typical High $501.19 | Facility | None | $125.89 | $181.97 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $117.49 | Professional | None | $70.79 | $70.79 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $107.15 Typical High $144.54 | Facility | None | $70.79 | $107.15 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $331.13 | Facility | None | $70.79 | $70.79 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $616.60 | Professional | None | $125.89 | $125.89 | $616.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $89.13 Median $912.01 Typical High $2,137.96 | Facility | None | $89.13 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $50.12 Median $104.71 Typical High $234.42 | Professional | None | $50.12 | $104.71 | $234.42 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
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 $35.48 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $35.48 | $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 $10.72 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.72 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.08 | $7.24 | $7.24 |
Where Indiana sits
The same service costs 2.0 times more in North Dakota than in Maryland. 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· 44th 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.