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 $64.57 Median $64.57 Typical High $1,995.26 | Professional | None | $64.57 | $64.57 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $16,218.10 Typical High $33,884.42 | Facility | None | $2,630.27 | $16,218.10 | $33,884.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,698.24 | $1,995.26 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $2,951.21 Typical High $4,073.80 | Professional | 50 · Both sides | $2,511.89 | $2,951.21 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $2,691.53 | Facility | None | $524.81 | $724.44 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,778.28 | Professional | None | $812.83 | $1,122.02 | $1,778.28 |
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 $32.36 Median $32.36 Typical High $512.86 | Professional | 52 · Reduced service | $32.36 | $32.36 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $208.93 | Professional | 53 · Discontinued | $12.88 | $12.88 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $1,148.15 | Professional | 54 · Surgery only | $48.98 | $48.98 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $154.88 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $154.88 |
Where Indiana sits
The same service costs 51.3 times more in Oklahoma than in North Carolina. 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· 12th of 51
$1,995
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.