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 $389.05 Median $389.05 Typical High $794.33 | Facility | None | $389.05 | $389.05 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $562.34 | Professional | None | $389.05 | $389.05 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $588.84 Typical High $776.25 | Facility | None | $389.05 | $588.84 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $602.56 | Professional | None | $389.05 | $389.05 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $588.84 Typical High $776.25 | Facility | None | $389.05 | $588.84 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $1,071.52 | Facility | None | $512.86 | $977.24 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $1,096.48 | Professional | None | $389.05 | $389.05 | $1,096.48 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $776.25 Median $794.33 Typical High $1,230.27 | Facility | None | $776.25 | $794.33 | $1,230.27 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $81.28 Median $380.19 Typical High $616.60 | Professional | None | $81.28 | $380.19 | $616.60 |
United Setting Professional Modifier None Typical Low $154.88 Median $389.05 Typical High $660.69 | Professional | None | $154.88 | $389.05 | $660.69 |
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 $194.98 Median $194.98 Typical High $199.53 | Professional | 52 · Reduced service | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $77.62 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $60.26 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $39.81 |
Where Indiana sits
The same service costs 1.7 times more in Alaska 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· 35th of 51
$389
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.