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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | None | $446.68 | $457.09 | $457.09 |
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 $446.68 Typical High $501.19 | Professional | None | $117.49 | $446.68 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $891.25 | Facility | None | $446.68 | $676.08 | $891.25 |
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 $851.14 | Professional | None | $125.89 | $125.89 | $851.14 |
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 $223.87 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $223.87 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $89.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $45.71 |
Where Indiana sits
The same service costs 10.0 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· 22nd of 51
$447
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.