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 $117.49 Median $162.18 Typical High $223.87 | Facility | None | $117.49 | $162.18 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $295.12 | Facility | None | $147.91 | $204.17 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $263.03 | Professional | None | $117.49 | $147.91 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $331.13 | Facility | None | $181.97 | $181.97 | $331.13 |
CareSource Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $295.12 Typical High $323.59 | Facility | None | $131.83 | $295.12 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $524.81 | Professional | None | $117.49 | $117.49 | $524.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $524.81 | Facility | None | $186.21 | $363.08 | $524.81 |
United Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $457.09 | Professional | None | $147.91 | $147.91 | $457.09 |
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 $58.88 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $11.75 |
Where Indiana sits
The same service costs 2.0 times more in Kansas than in Georgia. 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· 31st of 51
$148
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.