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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | None | $89.13 | $91.20 | $91.20 |
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 $89.13 Median $89.13 Typical High $120.23 | Professional | None | $89.13 | $89.13 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $134.90 Typical High $177.83 | Facility | None | $89.13 | $134.90 | $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 $147.91 Median $912.01 Typical High $2,137.96 | Facility | None | $147.91 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $81.28 Median $190.55 Typical High $1,122.02 | Professional | None | $81.28 | $190.55 | $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 $44.67 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $44.67 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $17.78 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.91 | $9.12 | $9.12 |
Where Indiana sits
The same service costs 17.4 times more in Wyoming than in Montana. 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· 42nd of 51
$91.20
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.