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 $707.95 Median $5,011.87 Typical High $9,772.37 | Facility | None | $707.95 | $5,011.87 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,023.29 | Professional | None | $660.69 | $707.95 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,513.56 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,348.96 | $2,089.30 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $16,982.44 Typical High $25,703.96 | Facility | None | $1,122.02 | $16,982.44 | $25,703.96 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $933.25 Typical High $16,595.87 | Facility | None | $524.81 | $933.25 | $16,595.87 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $8,912.51 Typical High $16,218.10 | Facility | None | $1,621.81 | $8,912.51 | $16,218.10 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,548.82 | $2,187.76 |
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 $331.13 Median $354.81 Typical High $512.86 | Professional | 52 · Reduced service | $331.13 | $354.81 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $204.17 | Professional | 53 · Discontinued | $131.83 | $141.25 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $154.88 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $102.33 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $102.33 |
Where Indiana sits
The same service costs 18.2 times more in California 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· 39th of 51
$1,585
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.