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 $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | None | $707.95 | $724.44 | $724.44 |
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 $707.95 Typical High $794.33 | Professional | None | $117.49 | $707.95 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,412.54 | Facility | None | $707.95 | $1,071.52 | $1,412.54 |
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 $1,348.96 | Professional | None | $125.89 | $125.89 | $1,348.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $275.42 Median $954.99 Typical High $2,290.87 | Facility | None | $275.42 | $954.99 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $190.55 Median $933.25 Typical High $2,041.74 | Professional | None | $190.55 | $933.25 | $2,041.74 |
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 $354.81 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $354.81 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $72.44 |
Where Indiana sits
The same service costs 13.2 times more in Hawaii 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· 15th of 51
$708
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.