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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | None | $87.10 | $89.13 | $89.13 |
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 $87.10 Median $87.10 Typical High $117.49 | Professional | None | $87.10 | $87.10 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $131.83 Typical High $177.83 | Facility | None | $87.10 | $131.83 | $177.83 |
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 $100.00 Median $354.81 Typical High $2,089.30 | Facility | None | $100.00 | $354.81 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $234.42 | Professional | None | $79.43 | $190.55 | $234.42 |
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 $43.65 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $43.65 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.71 | $8.91 | $8.91 |
Where Indiana sits
The same service costs 1.9 times more in Alaska than in New York. 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
$89.13
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.