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 $208.93 Median $257.04 Typical High $380.19 | Facility | None | $208.93 | $257.04 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $676.08 | Professional | None | $208.93 | $208.93 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $302.00 Typical High $416.87 | Facility | None | $194.98 | $302.00 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $363.08 | Professional | None | $186.21 | $208.93 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $363.08 | Facility | None | $204.17 | $204.17 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $549.54 Typical High $575.44 | Facility | None | $288.40 | $549.54 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $588.84 | Professional | None | $208.93 | $208.93 | $588.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $213.80 Median $416.87 Typical High $660.69 | Facility | None | $213.80 | $416.87 | $660.69 |
United Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $588.84 | Professional | None | $186.21 | $208.93 | $588.84 |
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 $104.71 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Where Indiana sits
The same service costs 1.6 times more in Arizona than in Rhode Island. 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· 46th of 51
$209
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.