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 $478.63 Typical High $602.56 | Facility | None | $338.84 | $478.63 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $602.56 | Professional | None | $338.84 | $338.84 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $338.84 | Professional | None | $263.03 | $316.23 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $501.19 Typical High $676.08 | Facility | None | $316.23 | $501.19 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $562.34 | Professional | None | $302.00 | $302.00 | $562.34 |
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 $398.11 Median $977.24 Typical High $977.24 | Facility | None | $398.11 | $977.24 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $812.83 | Professional | None | $354.81 | $354.81 | $812.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $281.84 Median $831.76 Typical High $2,137.96 | Facility | None | $281.84 | $831.76 | $2,137.96 |
United Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $512.86 | Professional | None | $316.23 | $338.84 | $512.86 |
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 $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
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 $51.29 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $51.29 |
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 2.9 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· 27th of 51
$355
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.