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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | None | $100.00 | $107.15 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $186.21 Typical High $501.19 | Facility | None | $125.89 | $186.21 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Professional | None | $107.15 | $107.15 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $162.18 Typical High $213.80 | Facility | None | $107.15 | $162.18 | $213.80 |
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 $75.86 Median $354.81 Typical High $2,089.30 | Facility | None | $75.86 | $354.81 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $234.42 | Professional | None | $60.26 | $89.13 | $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 $50.12 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $50.12 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $19.95 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $15.14 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.00 | $10.72 | $10.72 |
Where Indiana sits
The same service costs 4.4 times more in Alaska than in Hawaii. 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· 40th of 51
$107
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.