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 $512.86 Median $512.86 Typical High $1,000.00 | Facility | None | $512.86 | $512.86 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $501.19 Median $776.25 Typical High $1,023.29 | Facility | None | $501.19 | $776.25 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $954.99 | Professional | None | $501.19 | $512.86 | $954.99 |
CareSource Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $870.96 | Facility | None | $478.63 | $478.63 | $870.96 |
CareSource Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,000.00 Typical High $1,412.54 | Facility | None | $575.44 | $1,000.00 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,288.25 | Professional | None | $512.86 | $512.86 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $467.74 Median $954.99 Typical High $1,584.89 | Facility | None | $467.74 | $954.99 | $1,584.89 |
United Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,584.89 | Professional | None | $501.19 | $501.19 | $1,584.89 |
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 $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $102.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $51.29 |
Where Indiana sits
The same service costs 1.6 times more in Arizona than in Nebraska. 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· 14th of 51
$537
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.