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 $114.82 Median $114.82 Typical High $229.09 | Facility | None | $114.82 | $114.82 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $177.83 Typical High $239.88 | Facility | None | $120.23 | $177.83 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $162.18 | Professional | None | $89.13 | $89.13 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $338.84 Typical High $354.81 | Facility | None | $138.04 | $338.84 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | None | $120.23 | $120.23 | $123.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $72.44 Median $186.21 Typical High $954.99 | Facility | None | $72.44 | $186.21 | $954.99 |
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 $57.54 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.48 |
Where Indiana sits
The same service costs 1.7 times more in Arizona than in Hawaii. 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· 34th of 51
$120
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.