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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | None | $128.82 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $181.97 Typical High $501.19 | Facility | None | $125.89 | $181.97 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $117.49 | Professional | None | $39.81 | $39.81 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $229.09 Typical High $346.74 | Facility | None | $144.54 | $229.09 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $616.60 | Professional | None | $125.89 | $125.89 | $616.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $107.15 Median $912.01 Typical High $2,137.96 | Facility | None | $107.15 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $245.47 | Professional | None | $125.89 | $190.55 | $245.47 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
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 $64.57 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $25.70 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.88 | $13.80 | $13.80 |
Where Indiana sits
The same service costs 5.9 times more in North Dakota 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· 47th of 51
$117
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.