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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $34.67 Typical High $36.31 | Professional | None | $24.55 | $34.67 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $36.31 Typical High $37.15 | Facility | None | $28.84 | $36.31 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $37.15 | Professional | None | $15.85 | $15.85 | $37.15 |
CareSource Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
CareSource Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | None | $32.36 | $32.36 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $20.89 Typical High $21.38 | Professional | None | $16.98 | $20.89 | $21.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $33.11 Median $954.99 Typical High $2,187.76 | Facility | None | $33.11 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $7.59 Median $33.88 Typical High $40.74 | Professional | None | $7.59 | $33.88 | $40.74 |
United Setting Professional Modifier None Typical Low $13.18 Median $30.20 Typical High $45.71 | Professional | None | $13.18 | $30.20 | $45.71 |
2 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 55 · Aftercare only Typical Low $3.72 Median $5.13 Typical High $5.50 | Professional | 55 · Aftercare only | $3.72 | $5.13 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.47 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.45 | $3.47 | $3.63 |
Where Indiana sits
The same service costs 3.5 times more in Montana 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· 50th of 51
$15.85
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.