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 $120.23 Median $120.23 Typical High $239.88 | Facility | None | $120.23 | $120.23 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $186.21 Typical High $263.03 | Facility | None | $131.83 | $186.21 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $275.42 | Professional | None | $125.89 | $234.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $316.23 Typical High $346.74 | Facility | None | $144.54 | $316.23 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $346.74 | Professional | None | $128.82 | $128.82 | $346.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $75.86 Median $199.53 Typical High $912.01 | Facility | None | $75.86 | $199.53 | $912.01 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $398.11 | Professional | None | $125.89 | $125.89 | $398.11 |
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 $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
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 $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Where Indiana sits
The same service costs 2.3 times more in Texas 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· 5th of 51
$162
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.