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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | None | $549.54 | $562.34 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $190.55 Typical High $549.54 | Facility | None | $125.89 | $190.55 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $549.54 Typical High $616.60 | Professional | None | $117.49 | $549.54 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $831.76 Typical High $1,096.48 | Facility | None | $549.54 | $831.76 | $1,096.48 |
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 $162.18 Typical High $1,047.13 | Professional | None | $125.89 | $162.18 | $1,047.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $275.42 Median $912.01 Typical High $2,089.30 | Facility | None | $275.42 | $912.01 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $1,071.52 | Professional | None | $190.55 | $245.47 | $1,071.52 |
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 $275.42 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $275.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $109.65 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $56.23 |
Where Indiana sits
The same service costs 9.1 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· 7th of 51
$550
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.