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 $141.25 Median $151.36 Typical High $162.18 | Facility | None | $141.25 | $151.36 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $117.49 Median $151.36 Typical High $186.21 | Professional | None | $117.49 | $151.36 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $229.09 Typical High $302.00 | Facility | None | $151.36 | $229.09 | $302.00 |
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 $616.60 | Professional | None | $125.89 | $125.89 | $616.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $288.40 Median $489.78 Typical High $2,089.30 | Facility | None | $288.40 | $489.78 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $323.59 | Professional | None | $147.91 | $234.42 | $323.59 |
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 $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
Where Indiana sits
The same service costs 2.9 times more in Wyoming than in North Carolina. 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· 30th of 51
$151
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.