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 $776.25 Median $776.25 Typical High $1,548.82 | Facility | None | $776.25 | $776.25 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,778.28 | Facility | None | $758.58 | $1,202.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,148.15 | $2,041.74 |
CareSource Setting Facility Modifier None Typical Low $38.90 Median $69.18 Typical High $77.62 | Facility | None | $38.90 | $69.18 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,238.72 Typical High $2,238.72 | Facility | None | $912.01 | $2,238.72 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $3,235.94 | Professional | None | $812.83 | $812.83 | $3,235.94 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $3,162.28 | Facility | None | $870.96 | $2,089.30 | $3,162.28 |
United Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $2,511.89 | Professional | None | $794.33 | $794.33 | $2,511.89 |
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 $380.19 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
Where Indiana sits
The same service costs 2.6 times more in Alabama than in Florida. 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· 12th of 51
$1,148
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.