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 $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,570.40 | $2,818.38 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $190.55 Typical High $691.83 | Facility | None | $125.89 | $190.55 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $2,754.23 Typical High $3,090.30 | Professional | None | $117.49 | $2,754.23 | $3,090.30 |
CareSource Setting Facility Modifier None Typical Low $2,754.23 Median $4,168.69 Typical High $5,623.41 | Facility | None | $2,754.23 | $4,168.69 | $5,623.41 |
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 $5,248.07 | Professional | None | $125.89 | $125.89 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $213.80 Median $912.01 Typical High $3,548.13 | Facility | None | $213.80 | $912.01 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $2,884.03 | Professional | None | $125.89 | $213.80 | $2,884.03 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $218.78 | Professional | None | $125.89 | $125.89 | $218.78 |
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 $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,288.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $512.86 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $389.05 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $257.04 | $281.84 | $281.84 |
Where Indiana sits
The same service costs 37.2 times more in Wyoming than in North Carolina. 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· 4th of 51
$2,754
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.