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 $446.68 Median $446.68 Typical High $891.25 | Facility | None | $446.68 | $446.68 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $645.65 | Facility | None | $0.02 | $0.02 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $891.25 | Professional | None | $489.78 | $489.78 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $181.97 Typical High $199.53 | Facility | None | $100.00 | $181.97 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $1,318.26 | Facility | None | $524.81 | $1,174.90 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,318.26 | Professional | None | $478.63 | $478.63 | $1,318.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $478.63 Median $912.01 Typical High $2,187.76 | Facility | None | $478.63 | $912.01 | $2,187.76 |
United Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,479.11 | Professional | None | $467.74 | $467.74 | $1,479.11 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Where Indiana sits
The same service costs 2.3 times more in Arizona than in Idaho. 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· 13th of 51
$490
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.