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 $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $10,232.93 | Professional | None | $4,897.79 | $4,897.79 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $9,332.54 | Facility | None | $4,897.79 | $4,897.79 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $10,471.29 | Professional | None | $4,897.79 | $4,897.79 | $10,471.29 |
CareSource Setting Facility Modifier None Typical Low $14,791.08 Median $14,791.08 Typical High $15,135.61 | Facility | None | $14,791.08 | $14,791.08 | $15,135.61 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $10,471.29 | Facility | None | $5,623.41 | $5,623.41 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $5,623.41 Typical High $46,773.51 | Professional | None | $4,786.30 | $5,623.41 | $46,773.51 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $33,113.11 | Facility | None | $912.01 | $2,187.76 | $33,113.11 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $7,079.46 Median $8,709.64 Typical High $10,471.29 | Professional | None | $7,079.46 | $8,709.64 | $10,471.29 |
United Setting Professional Modifier None Typical Low $3,019.95 Median $5,128.61 Typical High $8,511.38 | Professional | None | $3,019.95 | $5,128.61 | $8,511.38 |
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 $2,454.71 Median $2,454.71 Typical High $5,011.87 | Professional | 52 · Reduced service | $2,454.71 | $2,454.71 | $5,011.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $977.24 Typical High $2,041.74 | Professional | 53 · Discontinued | $977.24 | $977.24 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $741.31 Median $741.31 Typical High $1,513.56 | Professional | 55 · Aftercare only | $741.31 | $741.31 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $489.78 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $489.78 | $489.78 | $1,023.29 |
Where Indiana sits
The same service costs 2.6 times more in Montana than in New York. 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· 39th of 51
$5,012
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.