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 $398.11 Median $398.11 Typical High $776.25 | Facility | None | $398.11 | $398.11 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | None | $389.05 | $398.11 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $588.84 Typical High $794.33 | Facility | None | $380.19 | $588.84 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $758.58 | Professional | None | $380.19 | $389.05 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $575.44 Typical High $776.25 | Facility | None | $389.05 | $575.44 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,023.29 Typical High $1,071.52 | Facility | None | $446.68 | $1,023.29 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $501.19 | Professional | None | $380.19 | $380.19 | $501.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $1,230.27 | Facility | None | $363.08 | $776.25 | $1,230.27 |
United Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $1,202.26 | Professional | None | $380.19 | $426.58 | $1,202.26 |
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 $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $39.81 |
Where Indiana sits
The same service costs 1.9 times more in Texas than in Illinois. 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· 31st of 51
$398
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.