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 $436.52 Typical High $575.44 | Facility | None | $331.13 | $436.52 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $489.78 | Professional | None | $331.13 | $331.13 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $501.19 Typical High $660.69 | Facility | None | $316.23 | $501.19 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $645.65 | Professional | None | $316.23 | $446.68 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $562.34 | Facility | None | $316.23 | $316.23 | $562.34 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,258.93 Typical High $1,380.38 | Facility | None | $562.34 | $1,258.93 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $501.19 Typical High $1,288.25 | Professional | None | $177.83 | $501.19 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $1,096.48 | Facility | None | $467.74 | $645.65 | $1,096.48 |
United Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $537.03 | Professional | None | $331.13 | $354.81 | $537.03 |
3 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 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 $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
Where Indiana sits
The same service costs 3.5 times more in Minnesota 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· 26th of 51
$447
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.