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 $239.88 Median $239.88 Typical High $478.63 | Facility | None | $239.88 | $239.88 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $257.04 | Professional | None | $239.88 | $239.88 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $234.42 Median $371.54 Typical High $512.86 | Facility | None | $234.42 | $371.54 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $275.42 | Professional | None | $218.78 | $218.78 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $54.95 Median $57.54 Typical High $102.33 | Facility | None | $54.95 | $57.54 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $630.96 Typical High $707.95 | Facility | None | $288.40 | $630.96 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $707.95 | Professional | None | $257.04 | $257.04 | $707.95 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $257.04 Median $912.01 Typical High $2,187.76 | Facility | None | $257.04 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $12.59 Median $74.13 Typical High $239.88 | Professional | None | $12.59 | $74.13 | $239.88 |
United Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $426.58 | Professional | None | $100.00 | $251.19 | $426.58 |
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 $120.23 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $47.86 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $38.02 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $25.70 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $25.70 |
Where Indiana sits
The same service costs 4.1 times more in Alaska than in Montana. 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· 49th of 51
$240
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.