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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | None | $263.03 | $263.03 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $380.19 Typical High $512.86 | Facility | None | $239.88 | $380.19 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $263.03 Typical High $354.81 | Professional | None | $107.15 | $263.03 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $61.66 Median $64.57 Typical High $117.49 | Facility | None | $61.66 | $64.57 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $794.33 Typical High $794.33 | Facility | None | $323.59 | $794.33 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $288.40 Typical High $630.96 | Professional | None | $61.66 | $288.40 | $630.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $363.08 Median $416.87 Typical High $2,187.76 | Facility | None | $363.08 | $416.87 | $2,187.76 |
United Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $436.52 | Professional | None | $257.04 | $288.40 | $436.52 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Where Indiana sits
The same service costs 3.9 times more in Arizona than in Montana. 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· 26th of 51
$263
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.