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 $123.03 Median $123.03 Typical High $245.47 | Facility | None | $123.03 | $123.03 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $123.03 | Professional | None | $120.23 | $123.03 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $181.97 Typical High $239.88 | Facility | None | $120.23 | $181.97 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $234.42 | Professional | None | $120.23 | $120.23 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $177.83 Typical High $234.42 | Facility | None | $117.49 | $177.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $331.13 Typical High $398.11 | Facility | None | $138.04 | $331.13 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $309.03 | Professional | None | $120.23 | $120.23 | $309.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $123.03 Median $239.88 Typical High $380.19 | Facility | None | $123.03 | $239.88 | $380.19 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $380.19 | Professional | None | $120.23 | $120.23 | $380.19 |
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 $60.26 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $60.26 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $23.99 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $12.30 |
Where Indiana sits
The same service costs 1.7 times more in Arizona than in New Mexico. 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· 13th of 51
$132
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.