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 $72.44 Median $5,011.87 Typical High $5,623.41 | Facility | None | $72.44 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | None | $72.44 | $72.44 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $7,413.10 Typical High $17,378.01 | Facility | None | $724.44 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $131.83 | Professional | None | $69.18 | $95.50 | $131.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $144.54 Typical High $199.53 | Professional | 50 · Both sides | $104.71 | $144.54 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $2,511.89 | Facility | None | $75.86 | $75.86 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $1,513.56 Typical High $2,630.27 | Facility | None | $97.72 | $1,513.56 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $269.15 | Professional | None | $70.79 | $93.33 | $269.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $199.53 Median $2,570.40 Typical High $4,168.69 | Facility | None | $199.53 | $2,570.40 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $138.04 | Professional | None | $75.86 | $93.33 | $138.04 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $141.25 | Professional | None | $70.79 | $87.10 | $141.25 |
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 $36.31 Median $36.31 Typical High $43.65 | Professional | 52 · Reduced service | $36.31 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $17.38 | Professional | 53 · Discontinued | $14.45 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | 54 · Surgery only | $54.95 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $13.18 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $8.71 |
Where Indiana sits
The same service costs 11.2 times more in Tennessee 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· 42nd of 51
$100
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.