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 $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
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 $2.51 Median $2.51 Typical High $117.49 | Professional | None | $2.51 | $2.51 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $2.51 Median $3.72 Typical High $5.01 | Facility | None | $2.51 | $3.72 | $5.01 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $229.09 Typical High $346.74 | Facility | None | $144.54 | $229.09 | $346.74 |
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 $12.88 Median $354.81 Typical High $2,089.30 | Facility | None | $12.88 | $354.81 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $8.91 Median $16.22 Typical High $234.42 | Professional | None | $8.91 | $16.22 | $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 $1.26 Median $1.26 Typical High $1.26 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.38 Typical High $0.38 | Professional | 55 · Aftercare only | $0.37 | $0.38 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.25 |
Where Indiana sits
The same service costs 50.1 times more in Massachusetts than in Indiana. 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· 51st of 51
$2.51
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.