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 $30.90 Median $42.66 Typical High $58.88 | Facility | None | $30.90 | $42.66 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.18 Median $44.67 Typical High $61.66 | Facility | None | $28.18 | $44.67 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $51.29 | Professional | None | $28.18 | $28.18 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $37.15 | Facility | None | $20.42 | $20.42 | $37.15 |
CareSource Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $77.62 Typical High $85.11 | Facility | None | $33.88 | $77.62 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $58.88 | Professional | None | $30.90 | $30.90 | $58.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $39.81 Median $51.29 Typical High $85.11 | Facility | None | $39.81 | $51.29 | $85.11 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $89.13 | Professional | None | $36.31 | $36.31 | $89.13 |
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 $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.57 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Where Indiana sits
The same service costs 1.9 times more in Texas than in Tennessee. 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· 20th of 51
$36.31
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.