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 $489.78 Median $489.78 Typical High $977.24 | Facility | None | $489.78 | $489.78 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $758.58 Typical High $1,071.52 | Facility | None | $537.03 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $954.99 | Professional | None | $524.81 | $524.81 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,445.44 Typical High $1,949.84 | Facility | None | $588.84 | $1,445.44 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,445.44 | Professional | None | $524.81 | $524.81 | $1,445.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $549.54 Median $912.01 Typical High $2,137.96 | Facility | None | $549.54 | $912.01 | $2,137.96 |
United Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,621.81 | Professional | None | $512.86 | $512.86 | $1,621.81 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
Where Indiana sits
The same service costs 1.7 times more in Arizona than in Hawaii. 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· 9th of 51
$550
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.