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 $16.22 Median $19.50 Typical High $22.39 | Facility | None | $16.22 | $19.50 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $23.44 Typical High $32.36 | Facility | None | $13.80 | $23.44 | $32.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $26.30 | Professional | None | $13.80 | $13.80 | $26.30 |
CareSource Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $50.12 | Facility | None | $27.54 | $27.54 | $50.12 |
CareSource Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $44.67 Typical High $158.49 | Facility | None | $22.39 | $44.67 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $16.22 Typical High $61.66 | Professional | None | $14.45 | $16.22 | $61.66 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $26.30 Median $43.65 Typical High $56.23 | Facility | None | $26.30 | $43.65 | $56.23 |
United Setting Professional Modifier None Typical Low $13.80 Median $15.14 Typical High $42.66 | Professional | None | $13.80 | $15.14 | $42.66 |
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 $8.13 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.40 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.62 |
Where Indiana sits
The same service costs 5.9 times more in Wyoming than in North Dakota. 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· 15th of 51
$17.78
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.