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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $39.81 | Professional | None | $38.90 | $39.81 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $181.97 Typical High $501.19 | Facility | None | $120.23 | $181.97 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $117.49 | Professional | None | $38.90 | $38.90 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $38.90 Median $58.88 Typical High $79.43 | Facility | None | $38.90 | $58.88 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $346.74 Typical High $346.74 | Facility | None | $144.54 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $1,023.29 | Professional | None | $125.89 | $125.89 | $1,023.29 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $234.42 Median $912.01 Typical High $2,137.96 | Facility | None | $234.42 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $776.25 | Professional | None | $125.89 | $234.42 | $776.25 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $218.78 | Professional | None | $125.89 | $125.89 | $218.78 |
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 $19.50 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.50 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $5.89 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.89 | $3.98 | $3.98 |
Where Indiana sits
The same service costs 25.1 times more in Wyoming than in Kentucky. 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· 50th of 51
$39.81
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.