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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | None | $52.48 | $53.70 | $53.70 |
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 $52.48 Median $52.48 Typical High $117.49 | Professional | None | $52.48 | $52.48 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $79.43 Typical High $107.15 | Facility | None | $52.48 | $79.43 | $107.15 |
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 $154.88 Median $912.01 Typical High $2,137.96 | Facility | None | $154.88 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $97.72 Median $190.55 Typical High $977.24 | Professional | None | $97.72 | $190.55 | $977.24 |
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 $26.30 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.30 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.25 | $5.37 | $5.37 |
Where Indiana sits
The same service costs 18.6 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
$53.70
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.