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 $338.84 Median $398.11 Typical High $501.19 | Facility | None | $338.84 | $398.11 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $501.19 | Professional | None | $338.84 | $338.84 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $316.23 | Professional | None | $208.93 | $269.15 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $489.78 Typical High $660.69 | Facility | None | $309.03 | $489.78 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $338.84 Typical High $457.09 | Professional | None | $177.83 | $338.84 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $616.60 | Facility | None | $338.84 | $338.84 | $616.60 |
CareSource Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,023.29 Typical High $1,023.29 | Facility | None | $416.87 | $1,023.29 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $954.99 | Professional | None | $371.54 | $371.54 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $331.13 Median $524.81 Typical High $2,187.76 | Facility | None | $331.13 | $524.81 | $2,187.76 |
United Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $562.34 | Professional | None | $331.13 | $371.54 | $562.34 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where Indiana sits
The same service costs 3.0 times more in Arizona than in Alabama. 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
$339
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.