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 $151.36 Median $186.21 Typical High $275.42 | Facility | None | $151.36 | $186.21 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | None | $147.91 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $74.13 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $29.51 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.79 | $15.14 | $15.14 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $147.91 | Professional | None | $114.82 | $134.90 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $218.78 Typical High $295.12 | Facility | None | $134.90 | $218.78 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | None | $134.90 | $134.90 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $190.55 | Facility | None | $107.15 | $107.15 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | None | $107.15 | $107.15 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $407.38 Typical High $602.56 | Facility | None | $208.93 | $407.38 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $398.11 | Professional | None | $147.91 | $147.91 | $398.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $245.47 Median $323.59 Typical High $954.99 | Facility | None | $245.47 | $323.59 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $138.04 Median $281.84 Typical High $371.54 | Professional | None | $138.04 | $281.84 | $371.54 |
United Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $177.83 | Professional | None | $134.90 | $134.90 | $177.83 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | JZ · No drug discarded | $134.90 | $134.90 | $134.90 |
Where Indiana sits
The same service costs 2.4 times more in Wyoming 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· 32nd of 51
$148
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.