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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $354.81 | Professional | None | $117.49 | $117.49 | $354.81 |
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 $354.81 Typical High $398.11 | Professional | None | $117.49 | $354.81 | $398.11 |
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 $645.65 | Professional | None | $125.89 | $125.89 | $645.65 |
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 $125.89 Median $234.42 Typical High $407.38 | Professional | None | $125.89 | $234.42 | $407.38 |
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 $58.88 Median $58.88 Typical High $177.83 | Professional | 52 · Reduced service | $58.88 | $58.88 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $70.79 | Professional | 53 · Discontinued | $23.44 | $23.44 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $53.70 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $35.48 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $35.48 |
Where Indiana sits
The same service costs 4.1 times more in Alaska 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· 16th of 51
$275
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.