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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | None | $97.72 | $100.00 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $467.74 | Facility | None | $125.89 | $177.83 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $128.82 | Professional | None | $97.72 | $97.72 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $147.91 Typical High $194.98 | Facility | None | $97.72 | $147.91 | $194.98 |
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 $97.72 Median $125.89 Typical High $478.63 | Professional | None | $97.72 | $125.89 | $478.63 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $2,089.30 | Facility | None | $199.53 | $354.81 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $234.42 | Professional | None | $100.00 | $173.78 | $234.42 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $208.93 | Professional | None | $125.89 | $125.89 | $208.93 |
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 $48.98 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $19.50 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.77 | $10.00 | $10.00 |
Where Indiana sits
The same service costs 2.0 times more in Alaska 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· 48th of 51
$100
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.