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 $338.84 Median $5,011.87 Typical High $11,220.18 | Facility | None | $338.84 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $741.31 | Professional | None | $316.23 | $338.84 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $4,786.30 Typical High $16,218.10 | Facility | None | $1,862.09 | $4,786.30 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $1,949.84 Typical High $2,630.27 | Professional | None | $512.86 | $1,949.84 | $2,630.27 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $12,302.69 Typical High $18,620.87 | Facility | None | $831.76 | $12,302.69 | $18,620.87 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,235.94 Typical High $5,888.44 | Facility | None | $645.65 | $3,235.94 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $4,466.84 | Facility | None | $912.01 | $954.99 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $4,168.69 Typical High $9,120.11 | Facility | None | $1,096.48 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $1,047.13 | Professional | None | $478.63 | $724.44 | $1,047.13 |
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 $158.49 Median $169.82 Typical High $323.59 | Professional | 52 · Reduced service | $158.49 | $169.82 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $67.61 Typical High $128.82 | Professional | 53 · Discontinued | $63.10 | $67.61 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $251.19 Typical High $549.54 | Professional | 54 · Surgery only | $234.42 | $251.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $50.12 Typical High $97.72 | Professional | 55 · Aftercare only | $46.77 | $50.12 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.88 Typical High $64.57 | Professional | 56 · Pre-op care only | $31.62 | $33.88 | $64.57 |
Where Indiana sits
The same service costs 10.2 times more in Texas 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· 13th of 51
$1,950
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.