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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $190.55 Typical High $512.86 | Facility | None | $125.89 | $190.55 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $489.78 Typical High $549.54 | Professional | None | $117.49 | $489.78 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $724.44 Typical High $977.24 | Facility | None | $489.78 | $724.44 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $346.74 Typical High $346.74 | Facility | None | $144.54 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $912.01 | Professional | None | $125.89 | $125.89 | $912.01 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $275.42 Median $912.01 Typical High $2,137.96 | Facility | None | $275.42 | $912.01 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $190.55 Median $478.63 Typical High $831.76 | Professional | None | $190.55 | $478.63 | $831.76 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
Where Indiana sits
The same service costs 7.1 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· 23rd of 51
$490
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.