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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
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 $33.88 Median $33.88 Typical High $117.49 | Professional | None | $33.88 | $33.88 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $33.88 Median $51.29 Typical High $67.61 | Facility | None | $33.88 | $51.29 | $67.61 |
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 $100.00 Median $912.01 Typical High $2,137.96 | Facility | None | $100.00 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $33.88 Median $190.55 Typical High $245.47 | Professional | None | $33.88 | $190.55 | $245.47 |
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 $16.98 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.76 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.39 | $3.47 | $3.47 |
Where Indiana sits
The same service costs 4.2 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· 49th of 51
$33.88
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.