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 $165.96 Median $3,467.37 Typical High $5,011.87 | Facility | None | $165.96 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $234.42 | Professional | None | $158.49 | $165.96 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,495.41 Typical High $21,877.62 | Facility | None | $2,137.96 | $5,495.41 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $2,570.40 Typical High $3,981.07 | Professional | None | $128.82 | $2,570.40 | $3,981.07 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $3,801.89 Typical High $5,754.40 | Facility | None | $251.19 | $3,801.89 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,162.28 Typical High $5,128.61 | Facility | None | $645.65 | $3,162.28 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $5,370.32 | Facility | None | $912.01 | $954.99 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,230.27 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,230.27 | Professional | None | $562.34 | $776.25 | $1,230.27 |
5 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 $77.62 Median $83.18 Typical High $117.49 | Professional | 52 · Reduced service | $77.62 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $46.77 | Professional | 53 · Discontinued | $31.62 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $125.89 Typical High $173.78 | Professional | 54 · Surgery only | $117.49 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $25.12 Typical High $35.48 | Professional | 55 · Aftercare only | $23.44 | $25.12 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.60 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.85 | $16.60 | $23.44 |
Where Indiana sits
The same service costs 12.6 times more in Ohio than in Nebraska. 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· 3rd of 51
$2,630
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.