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 $3,981.07 Median $3,981.07 Typical High $7,762.47 | Facility | None | $3,981.07 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $3,981.07 Typical High $4,168.69 | Professional | None | $3,890.45 | $3,981.07 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $5,888.44 Typical High $7,943.28 | Facility | None | $3,801.89 | $5,888.44 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $7,413.10 | Professional | None | $3,801.89 | $3,890.45 | $7,413.10 |
CareSource Setting Facility Modifier None Typical Low $3,630.78 Median $5,495.41 Typical High $7,244.36 | Facility | None | $3,630.78 | $5,495.41 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $4,466.84 Median $7,943.28 Typical High $10,715.19 | Facility | None | $4,466.84 | $7,943.28 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $9,549.93 | Professional | None | $3,890.45 | $3,890.45 | $9,549.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $7,079.46 Typical High $9,332.54 | Facility | None | $954.99 | $7,079.46 | $9,332.54 |
United Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $12,022.64 | Professional | None | $3,801.89 | $3,801.89 | $12,022.64 |
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 $1,949.84 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,949.84 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $389.05 | $398.11 | $398.11 |
Where Indiana sits
The same service costs 11.0 times more in Alabama than in Oklahoma. 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· 22nd of 51
$3,981
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.