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 $1,258.93 Median $1,513.56 Typical High $1,698.24 | Facility | None | $1,258.93 | $1,513.56 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,258.93 | $1,905.46 |
Ambetter Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $2,570.40 | Facility | None | $1,202.26 | $1,905.46 | $2,570.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,479.11 | Professional | None | $851.14 | $1,174.90 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $3,548.13 | Facility | None | $1,479.11 | $3,548.13 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $3,235.94 | Professional | None | $1,288.25 | $1,288.25 | $3,235.94 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $758.58 Median $1,949.84 Typical High $2,187.76 | Facility | None | $758.58 | $1,949.84 | $2,187.76 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $3,981.07 | Professional | None | $1,258.93 | $1,258.93 | $3,981.07 |
5 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 $630.96 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $125.89 |
Where Indiana sits
The same service costs 2.9 times more in Minnesota than in Alabama. 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· 41st of 51
$1,259
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.