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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $4,786.30 | Facility | None | $2,290.87 | $3,630.78 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $275.42 | Professional | None | $138.04 | $138.04 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $158.49 Typical High $173.78 | Facility | None | $87.10 | $158.49 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $3,090.30 Median $6,760.83 Typical High $7,413.10 | Facility | None | $3,090.30 | $6,760.83 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $6,760.83 | Professional | None | $2,691.53 | $2,691.53 | $6,760.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,344.23 Typical High $3,890.45 | Facility | None | $912.01 | $2,344.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $4,265.80 | Professional | None | $2,511.89 | $2,818.38 | $4,265.80 |
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 $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
Where Indiana sits
The same service costs 25.1 times more in Arizona than in Montana. 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· 47th 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.