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 $331.13 Median $5,011.87 Typical High $5,623.41 | Facility | None | $331.13 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $426.58 | Professional | None | $331.13 | $331.13 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $10,964.78 Typical High $22,908.68 | Facility | None | $741.31 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $630.96 | Professional | None | $295.12 | $467.74 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $707.95 Typical High $954.99 | Professional | 50 · Both sides | $436.52 | $707.95 | $954.99 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $5,248.07 | Facility | None | $363.08 | $363.08 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $3,090.30 Typical High $5,754.40 | Facility | None | $389.05 | $3,090.30 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $691.83 | Professional | None | $338.84 | $436.52 | $691.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $4,897.79 Typical High $7,413.10 | Facility | None | $912.01 | $4,897.79 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $645.65 | Professional | None | $363.08 | $537.03 | $645.65 |
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 $338.84 Median $426.58 Typical High $676.08 | Professional | None | $338.84 | $426.58 | $676.08 |
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 $165.96 Median $165.96 Typical High $213.80 | Professional | 52 · Reduced service | $165.96 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $87.10 | Professional | 53 · Discontinued | $66.07 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $323.59 | Professional | 54 · Surgery only | $245.47 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $42.66 |
Where Indiana sits
The same service costs 7.8 times more in Oklahoma 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· 38th of 51
$468
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.