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 $213.80 Median $213.80 Typical High $436.52 | Facility | None | $213.80 | $213.80 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $323.59 Typical High $426.58 | Facility | None | $213.80 | $323.59 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $416.87 | Professional | None | $213.80 | $213.80 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $323.59 Typical High $426.58 | Facility | None | $213.80 | $323.59 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $537.03 Typical High $588.84 | Facility | None | $239.88 | $537.03 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $575.44 | Professional | None | $213.80 | $213.80 | $575.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $213.80 Median $426.58 Typical High $676.08 | Facility | None | $213.80 | $426.58 | $676.08 |
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 $107.15 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $42.66 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $21.38 |
Where Indiana sits
The same service costs 7.6 times more in Alabama than in New Mexico. 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· 16th of 51
$229
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.