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 $933.25 Median $5,011.87 Typical High $7,244.36 | Facility | None | $933.25 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,445.44 | Professional | None | $954.99 | $1,023.29 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,288.25 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $53.70 | Professional | None | $38.90 | $43.65 | $53.70 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $2,511.89 Typical High $35,481.34 | Facility | None | $1,380.38 | $2,511.89 | $35,481.34 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,168.69 Typical High $6,760.83 | Facility | None | $645.65 | $4,168.69 | $6,760.83 |
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 $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,949.84 | $3,162.28 |
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 $478.63 Median $512.86 Typical High $724.44 | Professional | 52 · Reduced service | $478.63 | $512.86 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $288.40 | Professional | 53 · Discontinued | $190.55 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $218.78 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $144.54 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $144.54 |
Where Indiana sits
The same service costs 147.9 times more in Alaska 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· 15th of 51
$2,344
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.