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 $295.12 Median $295.12 Typical High $436.52 | Facility | None | $295.12 | $295.12 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $380.19 Typical High $588.84 | Facility | None | $218.78 | $380.19 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $426.58 | Professional | None | $213.80 | $295.12 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $446.68 Typical High $588.84 | Facility | None | $295.12 | $446.68 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $741.31 Typical High $812.83 | Facility | None | $331.13 | $741.31 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $1,513.56 | Professional | None | $295.12 | $295.12 | $1,513.56 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $338.84 Median $562.34 Typical High $1,047.13 | Facility | None | $338.84 | $562.34 | $1,047.13 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $676.08 | Professional | None | $213.80 | $213.80 | $676.08 |
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 $147.91 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $58.88 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $29.51 |
Where Indiana sits
The same service costs 6.8 times more in Wyoming 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· 38th of 51
$295
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.