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 $134.90 Median $134.90 Typical High $239.88 | Facility | None | $134.90 | $134.90 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | None | $131.83 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $190.55 Typical High $263.03 | Facility | None | $120.23 | $190.55 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $239.88 | Professional | None | $120.23 | $120.23 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $30.20 Median $45.71 Typical High $60.26 | Facility | None | $30.20 | $45.71 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $660.69 | Facility | None | $186.21 | $363.08 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $912.01 | Professional | None | $131.83 | $131.83 | $912.01 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $60.26 Median $676.08 Typical High $2,089.30 | Facility | None | $60.26 | $676.08 | $2,089.30 |
United Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $380.19 | Professional | None | $120.23 | $131.83 | $380.19 |
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 $66.07 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $26.30 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.18 | $13.49 | $13.49 |
Where Indiana sits
The same service costs 8.7 times more in Texas than in Kansas. 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· 11th of 51
$145
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.