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 $131.83 Median $131.83 Typical High $263.03 | Facility | None | $131.83 | $131.83 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | None | $128.82 | $131.83 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $257.04 | Facility | None | $128.82 | $194.98 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $257.04 | Professional | None | $128.82 | $128.82 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $257.04 | Facility | None | $128.82 | $194.98 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $331.13 Typical High $354.81 | Facility | None | $147.91 | $331.13 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $354.81 | Professional | None | $128.82 | $128.82 | $354.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $407.38 | Facility | None | $257.04 | $257.04 | $407.38 |
United Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $407.38 | Professional | None | $128.82 | $128.82 | $407.38 |
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 $64.57 Median $64.57 Typical High $66.07 | Professional | 52 · Reduced service | $64.57 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $26.30 | Professional | 53 · Discontinued | $25.70 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $13.18 |
Where Indiana sits
The same service costs 1.6 times more in Texas 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· 12th of 51
$145
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.