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 $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | None | $457.09 | $467.74 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $190.55 Typical High $512.86 | Facility | None | $125.89 | $190.55 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $457.09 Typical High $512.86 | Professional | None | $117.49 | $457.09 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $691.83 Typical High $933.25 | Facility | None | $457.09 | $691.83 | $933.25 |
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 $933.25 | Professional | None | $125.89 | $125.89 | $933.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $275.42 Median $954.99 Typical High $2,137.96 | Facility | None | $275.42 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $1,122.02 | Professional | None | $190.55 | $323.59 | $1,122.02 |
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 $229.09 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $229.09 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $45.71 | $46.77 | $46.77 |
Where Indiana sits
The same service costs 12.0 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· 7th of 51
$457
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.