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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $208.93 | Professional | None | $169.82 | $169.82 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $257.04 Typical High $338.84 | Facility | None | $165.96 | $257.04 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $309.03 | Professional | None | $165.96 | $199.53 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $245.47 Typical High $331.13 | Facility | None | $165.96 | $245.47 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $549.54 Typical High $602.56 | Facility | None | $239.88 | $549.54 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $575.44 | Professional | None | $218.78 | $218.78 | $575.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $199.53 Median $338.84 Typical High $912.01 | Facility | None | $199.53 | $338.84 | $912.01 |
United Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $281.84 | Professional | None | $165.96 | $186.21 | $281.84 |
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 $85.11 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $16.98 |
Where Indiana sits
The same service costs 1.8 times more in Arizona than in Alabama. 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· 23rd of 51
$204
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.